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目的探讨肺黏膜相关淋巴组织淋巴瘤的临床特征、诊断和治疗的方法。方法收集23例肺黏膜相关淋巴组织淋巴瘤的临床表现、实验室检查、影像、诊断及治疗资料,结合文献进行回顾性分析。结果 23例患者中,男14例,女9例;年龄22~71岁,中位年龄58岁;体检发现7例,其余15例有呼吸系统症状,1例右肺叩诊实音。肺CT表现大片实变影10例、肿块影9例多伴有充气支气管征,结节影10例、小片状网格影1例,1例纵隔隆突下肿物;1例患者胸腔缩小。免疫组化结果为CD20(+),cyclind-1(-),Ki-67指数介于5%~25%。10例患者采用化疗,9例患者采用手术治疗,其中1例患者手术加放疗,3例未治疗。结论肺黏膜相关淋巴组织淋巴瘤是一种低~中度恶性肿瘤,临床起病隐匿,多因体检和轻微呼吸道症状就诊。影像以肺实变影、肿块影伴充气支气管征为主。主要依靠病理及免疫组化检查确诊。目前治疗方案多样,仍存争议,有观察、手术、手术+化疗、单纯化疗、放疗等多种方案。预后极好,生存期长。
Objective To investigate the clinical characteristics, diagnosis and treatment of pulmonary mucosa-associated lymphoid tissue lymphoma. Methods The clinical manifestations, laboratory tests, imaging, diagnosis and treatment of 23 cases of pulmonary mucosa-associated lymphoid tissue lymphoma were collected and retrospectively analyzed. Results Among the 23 patients, 14 were male and 9 were female. The median age was 22 to 71 years. The median age was 58 years. Seven were found in the physical examination and the other 15 were respiratory symptoms. In 10 cases of pulmonary CT, there were 10 cases of massive real change, 9 cases of mass were accompanied by bronchial air bronchogram, 10 cases of nodules, 1 case of small patchy mesh, 1 case of mediastinum and 1 case of chest shrinkage . Immunohistochemical results for the CD20 (+), cyclind-1 (-), Ki-67 index ranged from 5% to 25%. Ten patients received chemotherapy and nine patients received surgery. One patient underwent surgery and radiotherapy, and three patients were untreated. Conclusions Pulmonary mucosa-associated lymphoid tissue lymphoma is a low-moderate malignant tumor with occult onset of clinical manifestations, mostly due to physical examination and mild respiratory symptoms. The image of the lung real shadow, mass shadow with bronchial signs of inflatable. Mainly rely on pathological and immunohistochemical examination confirmed. The current treatment options varied, still controversial, there are observation, surgery, surgery + chemotherapy, chemotherapy alone, radiotherapy and other programs. Excellent prognosis, long survival.