原发性甲状腺淋巴瘤的诊断及临床分析

发布时间：2018-03-25 12:47

本文选题：甲状腺淋巴瘤　切入点：病理　出处：《中国医学科学院学报》2017年03期

【摘要】：目的总结原发性甲状腺淋巴瘤不同亚型的诊断特征及临床预后,提高诊断和治疗的水平。方法回顾性分析了北京协和医院1998年1月至2014年12月收治的27例原发性甲状腺淋巴瘤患者的临床资料,其中病理类型不能分类的B细胞淋巴瘤5例,黏膜相关性淋巴瘤(MALT)9例,弥漫大B细胞淋巴瘤(DLBCL)12例,T细胞淋巴瘤1例。结果27例患者中,21例(77.8%)为无痛性颈部肿大。7例行术前穿刺病理检查的患者中,2例(28.6%)回报可疑淋巴瘤;其中,3例DLBCL的淋巴瘤阳性回报率为66.7%,3例MALT为0,1例不能分类的B细胞淋巴瘤为0。25例行术中冰冻检查的患者中,16例(64.0%)回报为淋巴瘤或不除外淋巴瘤,其中不能分类的B细胞淋巴瘤阳性率66.7%,MALT阳性率77.8%,DLBCL阳性率58.3%,T细胞淋巴瘤阳性率为0。所有患者总体生存期估值为(89.3±12.4)个月,总体5年生存率为61.6%。合并淋巴瘤相关症状患者的生存期估值为31.6个月,明显短于无相关症状的97.9个月(P=0.032),年龄、性别、肿瘤直径、肿瘤分期、国际预后指数、气管狭窄、乳酸脱氢酶水平、手术肿瘤残留、病理分型等因素对生存期估值的影响无统计学意义(P均0.05)。结论 DLBCL穿刺病理阳性率最高,MALT冰冻病理阳性率最高,术中冰冻病理的恶性诊断率高于术前穿刺病理。合并淋巴瘤相关症状可能为预后的不良因素。
[Abstract]:Objective to summarize the diagnostic features and prognosis of primary thyroid lymphoma subtypes, improve diagnosis and treatment level. Methods Retrospective analysis of the clinical data of 27 cases in Peking Union Medical College Hospital from January 1998 to December 2014 were patients with primary thyroid lymphoma, including 5 cases of B cell lymphoma pathological types cannot be classified, mucosa associated lymphoid tissue lymphoma (MALT) in 9 cases, diffuse large B cell lymphoma (DLBCL) in 12 cases, 1 cases of T cell lymphoma. Results of the 27 patients, 21 cases (77.8%) as a painless neck swelling.7 routine preoperative biopsy patients, 2 cases (28.6%) return suspicious lymphoma; among them, 3 cases of lymphoma positive returns the rate of DLBCL was 66.7%, 3 cases of B cell lymphoma MALT 0,1 cases of classification for frozen section examination in 0.25 cases of patients, 16 cases (64%) in return for lymphoma or not except lymph tumor, which can not be classified B fine The positive rate of cell lymphoma 66.7%, MALT positive rate was 77.8%, the positive rate of DLBCL was 58.3%, the positive rate of T cell lymphoma was 0. of all their overall survival value (89.3 + 12.4) months, the overall 5 year survival rate for 61.6%. patients with lymphoma related symptoms and survival estimates for 31.6 months and 97.9 months were significantly shorter no related symptoms (P=0.032), age, gender, tumor size, tumor staging, international prognostic index, tracheal stenosis, levels of lactate dehydrogenase, surgical effect of residual tumor, pathological type and other factors on the survival of the valuation was not statistically significant (P < 0.05). Conclusions the positive rate of DLBCL biopsy, frozen MALT the highest positive rate of pathological diagnosis, malignant intraoperative frozen pathology was higher than that of preoperative biopsy. With lymphoma related symptoms may be adverse prognostic factors.

【作者单位】：中国医学科学院
【分类号】：R736.1

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