原发性宫颈淋巴瘤病例报道1例并文献复习

发布时间：2018-03-06 14:37

本文选题：淋巴瘤　切入点：宫颈　出处：《广西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的通过1例原发性宫颈淋巴瘤(LUCX)的临床病例报道,并对国内外文献报道的病例进行复习,总结该疾病的临床特点和诊疗方案,以提高对该疾病的认识。方法报道了我院诊治的1例原发性LUCX病例,并在PubMed、万方、中国知网、维普数据库上检索2002年到2016年报道的病例,进行临床总结。结果本文报道的1例原发性LUCX病例,55岁女性,绝经后不规则阴道流血,妇检见右侧宫颈外生型菜花样肿物,病理活检诊断为弥漫大B细胞淋巴瘤。行根治性子宫切除术+双侧附件切除术+盆腔淋巴结清扫术+腹主动脉旁淋巴结切除术,术后随访16个月未见复发。本文回顾了以往报道的原发性LUCX病例,总结临床特点如下:(1)59例患者的发病年龄分布在22~85岁,平均46.7岁;(2)大部分(67.8%)的患者主要症状为阴道流血,其余少部分患者表现为宫颈肿物、阴道排液和胃肠道症状等;(3)大部分患者就诊时为早期,70.8%为Ann Arbor IE期,50%为FIGO IB期;(4)所有患者病理类型均为非霍奇金淋巴瘤(NHL),其中88.1%为B细胞来源,8.5%为T细胞来源;(5)94.9%的患者采用化疗或化疗为基础的综合治疗;(6)59例患者中,生存期最短为6个月,最长超过180个月,6例死亡,其中2例IE期,2例IIE期,2例IVE期。结论原发性LUCX是临床罕见病,好发于绝经前期,病理类型以DLBCL最常见,该病经早期诊断和治疗后预后良好,但由于该病临床症状无特异性,容易造成漏诊和误诊。该病目前尚无标准的治疗方案,以化疗为基础的综合治疗是最常用的治疗手段。临床分期是影响预后的最主要因素。
[Abstract]:Objective to report a case of primary cervical lymphoma (LUCX) and review the cases reported in the literature at home and abroad, and summarize the clinical features and diagnosis and treatment of the disease. Methods A case of primary LUCX was reported in our hospital. Results A case of primary LUCX was reported in a 55-year-old female with irregular postmenopausal vaginal bleeding. Diffuse large B-cell lymphoma was diagnosed by pathological biopsy. Radical hysterectomy, bilateral appendage resection, pelvic lymph node dissection, para-aortic lymphadenectomy, There was no recurrence after 16 months of follow-up. The clinical features of the previously reported cases of primary LUCX were summarized as follows: the age distribution of the onset of primary LUCX was 22 to 85 years old (mean 46.7 years old), and the main symptom of the patients was vaginal bleeding. A small number of other patients presented with cervical neoplasms, Vaginal effusion and gastrointestinal symptoms (70.8%, Ann Arbor IE, 50%, FIGO IB) all the pathological types were non-Hodgkin 's lymphoma, of which 88.1% were B cell origin (8.5%, T cell origin, 594.9%). Of the 659 patients who were treated with chemotherapy or chemotherapy-based comprehensive therapy, The shortest survival time was 6 months, and the longest death was over 180 months in 6 cases, of which 2 cases were in IE stage and 2 cases in IIE stage and 2 cases in IVE stage. Conclusion Primary LUCX is a rare clinical disease, which is prone to premenopausal stage. DLBCL is the most common pathological type. The prognosis of the disease is good after its early diagnosis and treatment, but it is easy to cause missed diagnosis and misdiagnosis due to the lack of specificity of clinical symptoms. Chemotherapy-based comprehensive therapy is the most commonly used treatment, and clinical staging is the most important factor affecting prognosis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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