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原发甲状腺淋巴瘤的临床特征及预后

Clinical Characteristics and Prognosis of Primary Thyroid Lymphoma Patients

  • 摘要:
    目的 探讨原发甲状腺淋巴瘤(PTL)的临床表现、病理特点、治疗方案及预后,以期为该病的诊断和治疗提供参考。
    方法 回顾性分析经病理证实的13例PTL患者的临床病理特征、诊断治疗及预后资料。
    结果 所有患者均为B细胞非霍奇金淋巴瘤,其中结外边缘区淋巴瘤3例,弥漫大B细胞淋巴瘤10例;早期(Ⅰ~Ⅱ期)10例,晚期(Ⅲ~Ⅳ期)3例;除1例患者仅手术切除外,其余均进行了多药化疗或联合局部放疗;13例患者中位生存时间99.5(22~250)月,随访期超过5年的10例患者5年生存率为100%。
    结论 PTL发病率低,以甲状腺结节为主要症状起病,半数以上可伴有桥本氏甲状腺炎,病理类型以B细胞非霍奇金淋巴瘤为主,CHOP方案为主的化疗对绝大多数患者有效且均有较好的预后。

     

    Abstract:
    Objective To explore the clinical manifestation, pathological features, treatment regimen and prognosis of primary thyroid lymphoma (PTL) patients.
    Methods We analyzed retrospectively the clinicopathologic features, diagnosis and treatment of 13 PTL patients confirmed by pathology.
    Results All patients were B cell non-Hodgkin lymphoma, including three cases of extranodal marginal zone lymphoma and 10 cases of diffuse large B cell lymphoma; 10 patients were in the early stage (stage Ⅰ and Ⅱ) and three patients with advanced stage (stage Ⅲ-Ⅳ); only one patient accepted surgical resection and the rest accepted multi-drug chemotherapy or combined with local radiotherapy; the median survival time was 99.5 months and the 5-year survival rate was 100%.
    Conclusion The incidence of PTL is low. Thyroid nodules are the main symptoms. More than half of them are accompanied with Hashimoto's thyroiditis. Main pathological type is B cell non-Hodgkin lymphoma. CHOP-based chemotherapy is effective for most of the patients with good prognosis.

     

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