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目的探讨恶性淋巴瘤侵及泌尿生殖系的临床特点。方法报告恶性淋巴瘤侵及泌尿生殖系3例。例1,男,68岁,主诉为右侧腰部不适1个月。CT扫描示右肾门处4.0 cm×5.5 cm软组织影,密度均匀,右腰大肌自肾下极至髂内肌水平弥漫增粗,内见低密度软组织影。例2,男,72岁,主诉为左下肢肿胀2周。CT检查示左精囊软组织肿物,直径2.5 cm;左髂动脉分叉处6.5 cm×4.5 cm软组织肿块。例3,女,48岁,主诉为发热1个月。CT检查示双侧肾上腺区8.0 cm×6.0 cm,7.0 cm×6.5 cm实性占位,界限清晰,密度不均。结合文献复习,对此类疾病的发病率、临床特点、手术治疗和预后进行总结。结果3例患者均手术治疗,原发部位分别为腹膜后及盆腔淋巴结,肾脏、精囊、肾上腺受累各1例,病理类型均为非霍奇金弥漫性大B细胞淋巴瘤。例1术后2个月死亡。例2、3术后行CHOP方案化疗,分别随访4个月、2年,均无瘤生存。结论淋巴瘤侵及泌尿生殖系统临床症状不典型,预后较差。此类患者手术效果不佳,治疗应以化疗、放疗为主。手术探查对于明确诊断有积极意义。
Objective To investigate the clinical features of malignant lymphoma invading genitourinary system. Methods Report of malignant lymphoma invading genitourinary tract in 3 cases. Example 1, male, 68 years old, complained of right lumbar discomfort for 1 month. CT scan showed a soft tissue shadow of 4.0 cm × 5.5 cm at the right renal portal with a uniform density. The right psoas muscle diffused thickly from the lower pole of the kidney to the medial floor of the iliac crest. Example 2, male, 72 years old, the main complaint was swollen left lower limb for 2 weeks. CT examination showed left seminal vesicle soft tissue mass, diameter 2.5 cm; left iliac artery bifurcation 6.5 cm × 4.5 cm soft tissue mass. Example 3, female, 48 years old, the chief complaint was fever for 1 month. CT examination showed that the bilateral adrenal gland 8.0 cm × 6.0 cm, 7.0 cm × 6.5 cm solid occupying, clear boundaries, uneven density. Combined with literature review, the incidence of these diseases, clinical features, surgical treatment and prognosis were summarized. Results All the 3 patients were operated on. The primary sites were 1 case of retroperitoneal and pelvic lymph nodes, 1 case of kidney, seminal vesicle and adrenal gland. The pathological types were all non-Hodgkin’s diffuse large B-cell lymphoma. Example 1 2 months after the death. Cases 2,3 postoperative CHOP regimen chemotherapy, were followed up for 4 months, 2 years, no tumor-free survival. Conclusion Lymphoma invading genitourinary system clinical symptoms are not typical, the prognosis is poor. Surgery in such patients is not good, the treatment should be chemotherapy, radiotherapy-based. Surgical exploration for the positive diagnosis of a positive meaning.