原发性肺淋巴瘤及肺淋巴瘤样肉芽肿临床病理及治疗分析.docVIP

原发性肺淋巴瘤及肺淋巴瘤样肉芽肿临床病理及治疗分析 　【关键词】 肺淋巴瘤；,,淋巴瘤样肉芽肿病；,,临床病理；,,治疗 　　Clinicopathological characteristics and therapy of primary pulmonary lymphoma and lymphomatoid granulomatosis 　　【Abstract】 AIM: To explore the clinicopathological characteristics and therapentic strategies of primary pulmonary lymphoma (PPL) and lymphomatoid granulomatosis (PLG). METHODS: The clinicopathological characteristics and the experience of surgical treatment of 10 cases of PPL and 2 of PLG were analyzed retrospectively. All cases were operated and pathologically confirmed. RESULTS: PPL accounted for 10 (0.5%) of 1887 cases of primary pulmonary malignant carcinoma in the same period, and PLG for 2 (0.1%) of 1887 cases. Eight cases were nonHodgkins lymphoma (Btype) confirmed by pathology, of them 2 cases died within 3 years postoperatively. The other cases were Hodgkins disease and died within 3 years postoperatively. Two cases were PLG. CONCLUSION: PPL and PLG are clinically rare with typical clinicopathological characteristics respectively. The correct diagnosis is difficult preoperatively. Managment modalities for PPL include surgical theatment,postoperative radiotherapy and chemotherapy. Surgical treatment is the first choice for PLG. 　　【Keywords】 lung lymphoma; lymphomatoid granulomatosis; pathology; treatment 　　【摘要】 目的: 探讨原发性肺淋巴瘤（ PPL）和肺淋巴瘤样肉芽肿（PLG）的临床病理和治疗预后. 方法：回顾分析10例PPL和2例PLG的临床病理特征和治疗经验. 12例临床病例均经过手术治疗和手术后病理证实. 结果：PPL和PLG分别占同期手术的肺恶性肿瘤的0.5%（10/1887）和0.1%（2/1887）. 8例手术后病理诊断为非霍奇金淋巴瘤（B细胞型），其中2例在手术后3 a内死亡；2例为霍奇金病，均在手术后3 a内死亡. 2例为PLG. 结论：PPL和PLG在临床上极少见，它们都起源于支气管黏膜相关的淋巴组织，包括支气管黏膜下组织和动静脉周围的淋巴组织，但各自有其典型的临床病理学特征. 治疗PPL包括手术和手术后放疗、正规化疗. PLG以手术治疗为首选. 　　【关键词】 肺淋巴瘤； 淋巴瘤样肉芽肿病； 临床病理； 治疗 　　0引言 　　原发性肺淋巴瘤（primary pulmonary lymphoma, PPL）是少见的结外型淋巴瘤，它起源于支气管黏膜相关的淋巴组织［1］；肺淋巴瘤样肉芽肿（pulmonary lymphomatoid granulomatosis, PLG）更为罕见，主要由血管中心性淋巴组织增生和血管炎性浸润引起. PPL与PLG有许多共同之处，均为系统性肉芽肿病. PLG介于良性淋巴增生与恶性淋巴瘤之间，需警惕PLG发展为恶性淋巴瘤. 200001/200510解放军总医院胸外科共收治10例PPL和2例PLG例患者，其中2例在术前经皮肺穿刺活检病理学明确诊断为PPL，其余8例PPL和2例PLG患者均经手术后病理证实. 我们对临床