咽喉部非霍奇金淋巴瘤23例回顾性分析

发布时间：2018-02-04 23:50

本文关键词： 非霍奇金淋巴瘤咽喉部临床诊断　出处：《重庆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨咽喉部非霍奇金淋巴瘤(NHL)的发病情况、临床特点、诊断要点及误诊原因,为临床医师对该病的早期诊断及治疗提供一定的经验及临床依据。方法对2012年~2016年3月我院收治的23例咽喉部非霍奇金淋巴瘤患者的完整的临床资料作回顾性分析。结果男:女=1:1.3。平均年龄56.96岁。平均病程3.83个月。B细胞来源20例,占86.96%,T细胞来源3例,占13.04%。临床表现主要为咽痛、咽异物感,15例,占65.22%,其次为颈部包块,5例,占21.74%。发病部位主要为扁桃体,17例(73.91%),鼻咽部3例(13.04%),舌根3例(13.04%)。A组20例,B组3例。其中17例(73.91%)有多次就诊经历,6例(26.09%)经多次活检确诊。4例予化疗,2例达部分缓解(PR),2例达稳定(SD);1例予放疗+化疗,肿瘤达完全缓解(CR)。3例予以手术切除病变。结论咽喉部非霍奇金淋巴瘤表现无特异性,早期表现易与咽喉部炎症等相混淆,详尽的病史询问、体格检查、实验室检查及影像学检查对诊断及鉴别诊断有参考价值,但误诊及漏诊率仍较高,故应引起重视,采取措施,以提高早期诊断及治疗水平。其治疗方案主要为放疗、化疗或放化疗联合,可收到较好的临床效果,是否需联合手术治疗尚无定论。
[Abstract]:Objective to investigate the incidence, clinical features, diagnosis and misdiagnosis of non-Hodgkin 's lymphoma in pharynx and larynx. Methods from 2012 to March 2016, 23 patients with non-Hodgkin 's lymphoma of pharynx and larynx were treated in our hospital. Retrospective analysis of bed data. Results male:. The mean age was 56.96 years. The mean course of disease was 3.83 months. The main clinical manifestations were pharynx pain, foreign body sensation of pharynx in 15 cases (65.22%), and neck mass in 5 cases. The main site of the disease was tonsil in 17 cases (73.91), nasopharynx in 3 cases (13. 04), tongue root in 3 cases (13. 04) and group A (20). Group B (3 cases, including 17 cases (73.91)), 6 cases (26.09) confirmed by multiple biopsies, 4 cases were given chemotherapy and 2 cases had partial remission (PRR). 2 cases reached stable SDN; One case was treated with radiotherapy and chemotherapy, and 3 cases with complete tumor remission were resected by operation. Conclusion there is no specificity in laryngeal non-Hodgkin 's lymphoma, and the early manifestations are easily confused with pharyngopharyngeal inflammation. Detailed medical history examination, physical examination, laboratory examination and imaging examination have reference value for diagnosis and differential diagnosis, but the rate of misdiagnosis and missed diagnosis is still high. Therefore, attention should be paid to it and measures should be taken. In order to improve the level of early diagnosis and treatment, the main treatment regimen is radiotherapy, chemotherapy or combination of radiotherapy and chemotherapy.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R739.6

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