【作者】 王华庆； 韩霞； 刘贤明； 邱立华； 张会来； 钱正子； 李维； 李兰芳； 崔秀珍； 郝希山；

【Author】 WangHua-qing~*,Han Xia,Liu xianming,Qiu lihua,Zhang huilai,Qian zhengzi,Li wei,Li lanfang,Cui xiuzhen,Hao xishan Tianjin Medical University affiliated Cancer Hospital,Tianjin 300060,China

【机构】 天津医科大学肿瘤医院淋巴肿瘤科天津市肿瘤防治重点实验室；

【摘要】 目的探讨原发性肾上腺恶性淋巴瘤(Primary Adrenal Lymphoma,PAL)的临床特征、诊治要点及预后。方法回顾性分析天津市肿瘤医院1975年1月至2008年10月间收治的5例PAL患者的症状、体征,胸片/胸CT、腹部B超/CT/MRI,血、尿、便常规、肝肾功能、骨髓检查结果及血、尿儿茶酚胺等临床资料,并结合国内外文献进行分析。结果5例患者中,1例因常规体检发现,4例以腰痛或腹痛就诊。实验室检查无明显异常。影像学检查仅肾上腺区发现肿物,临床诊断为"肾上腺癌"或"嗜铬细胞瘤",但术后病理诊断却证实为非霍奇金淋巴瘤(NHL),其中B细胞淋巴瘤(B-NHL)3例,T细胞淋巴瘤(T-NH-L)2例。5例患者术后均接受了CHOP或CHOP样方案化疗为主的综合治疗。随访至2008年1O月,1例B小细胞性淋巴瘤患者存活8年,余4例均在1年内死亡。结论PAL是极为罕见的结外淋巴瘤,临床和影像学表现不典型,误诊率极高,确诊依靠组织病理学检查。病理类型主要为NHL,B-NHL和T-NHL均不少见。术后5年生存率仅20%(1/5),似病理类型影响该病的预后。更多还原

【Abstract】 Objective To describe the clinical features,diagnosis,treatment and prognosis of primary adrenal lymphoma.Methods The retrospective clinical data of 5 cases of PAL admitted to our hospital between 1975 and 2008 was analyzed and the related literature was reviewed.Results 1 was occasionally detected by health examination,4 patients complained of lumbago or stomachache.The adrenal tumor were found by imaging examination,but the diagnosis of non-Hodgkin lymphoma was confirmed by histopathological examination.3 were B-cell origin and 2 were T-cell origin.They all received CHOP or CHOP-like chemotherapy.Follow up was over in October,2008,One patient has been alive for 8 yearsand other 4 patients died withen 1 year.Conclusions PAL is a rare malignancy.The presenting symptoms and imaging modalities of PAL were nonspecific and misdiagnosis rate was high.The definitive diagnosis of PAL depended on cytology and immunohistochemistry of adrenal tissue.The pathology is mainly NHL,B-NHL and T-NHL was not few.5-year survival rate was only 20%(1/5).It is likely that pathology affect prognosis.更多还原