15例鼻腔鼻窦非霍奇金淋巴瘤患者的临床特征分析

发布时间：2018-03-27 23:04

本文选题：结外非霍奇金淋巴瘤　切入点：NK/T细胞　出处：《临床耳鼻咽喉头颈外科杂志》2017年21期

【摘要】：目的:探讨鼻腔鼻窦非霍奇金淋巴瘤不同组织学亚型的临床表现、影像学特征、免疫组织学类型及其早期诊断价值。方法:回顾性分析北京大学第三医院耳鼻咽喉科2010-2016年经手术及活检病理证实的15例鼻腔鼻窦非霍奇金淋巴瘤患者的临床、影像学和病理资料,并对不同病理分型的临床症状、影像学特点进行统计分析。结果:15例患者中NK/T淋巴瘤患者9例,中位年龄39岁,其中男5例,女4例;弥漫大B淋巴瘤患者6例,中位年龄64岁,其中男3例,女3例,组间年龄差异有统计学意义(P0.05)。弥漫大B淋巴瘤按照病理学Han′s分型可分为生发中心型(1例)和非生发中心型(5例)。NK/T及弥漫大B淋巴瘤患者临床症状中鼻塞、复视、溢泪、突眼症状差异有统计学意义(均P0.05)。不同病理类型2组间影像特点中肿物外侵下鼻甲及肿物外侵眼眶差异有统计学意义(均P0.05)。NK/T淋巴瘤患者免疫组织化学检测结果中CD56(+)8例,CD3(+)5例,EBER(+)9例;生发中心型弥漫大B淋巴瘤患者(1例)免疫组织化学:Bcl-6(+)、CD10(+),MUM1(-);非生化中心型弥漫大B淋巴瘤患者Bcl-6(+)5例,MUM1(+)5例,CD10(-)5例。结论:(1)NK/T淋巴瘤在中国人鼻腔鼻窦非霍奇金淋巴瘤中发病率较高,与之对应弥漫大B淋巴瘤发病率较低,这与亚洲地区其他国家的发病率相似,但与西方国家的发病率差别较大;(2)早期出现复视、溢泪及突眼症状,并且影像学上出现眼眶外侵的鼻腔鼻窦肿瘤患者应高度怀疑弥漫大B淋巴瘤;肿瘤的早期诊断对早期治疗尤为重要;(3)组织病理学:NK/T淋巴瘤患者免疫组织化学结果中CD56及EBER阳性率较高;弥漫大B细胞淋巴瘤MUM1阳性率高。
[Abstract]:Objective: to investigate the clinical and imaging features of different histological subtypes of non-Hodgkin 's lymphoma in nasal cavity and paranasal sinus. Methods: the clinical data of 15 patients with non-Hodgkin 's lymphoma of nasal cavity and paranasal sinus confirmed by operation and biopsy in Department of Otorhinolaryngology of third Hospital of Peking University from 2010 to 2016 were retrospectively analyzed. The clinical symptoms and imaging features of different pathological types were statistically analyzed. Results 9 cases of NK/T lymphoma were found in 15 cases, with a median age of 39 years, including 5 males and 4 females. There were 6 cases of diffuse large B lymphoma with a median age of 64 years, including 3 males and 3 females. According to Han's classification, diffuse large B lymphoma can be divided into germinal center type (n = 1), non-germinal center type (n = 5) and diffuse large B lymphoma (n = 5). There were significant differences in exophthalmic symptoms between two groups (all P 0.05). There were significant differences in tumor invasion of inferior turbinate and orbit between two groups with different pathological types (all of the patients with P0.05).NK/T lymphoma were detected by immunohistochemistry). CD56 (n = 8) and CD3 (n = 5); One case of germinal center diffuse large B lymphoma) Immunohistochemistry: Bcl-6; Bcl-6 of non-biochemistry center type diffuse large B lymphoma; 5 cases of Muml (5 cases of CD10P). Conclusion: 1 NKT lymphoma in Chinese nasal cavity and paranasal sinuses is not Hodgkin's lymphoid. The incidence of tumor is high, The incidence of diffuse large B lymphoma is relatively low, which is similar to that of other countries in Asia, but different from that of western countries. Patients with nasal cavity and paranasal sinus tumors with orbital extraorbital invasion should be highly suspected of diffuse large B lymphoma. Early diagnosis of tumor is very important for early treatment. The positive rates of CD56 and EBER are higher in the immunohistochemical results of the patients with tumor than in the patients with diffuse large B-cell lymphoma. The positive rate of MUM1 in diffuse large B-cell lymphoma is high.
【作者单位】：北京大学第三医院耳鼻咽喉科;
【分类号】：R739.6

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