61例原发性肾淋巴瘤临床诊治分析

发布时间：2018-04-19 19:53

本文选题：肾肿瘤 + 淋巴瘤　；参考：《中国癌症杂志》2017年07期

【摘要】：背景与目的:原发性肾淋巴瘤(primary renal lymphoma,PRL)在临床上较罕见,术前诊断较困难,易误诊为肾癌。该研究旨在总结并探讨PRL的临床分期、病理类型、诊治及预后的特点。方法:回顾性分析国内1981—2014年个案报道的61例PRL患者的临床资料。结果:61例患者中,男性34例(55.7%),女性27例(44.3%),男女比例为1.3∶1.0,发病年龄为3~84岁,50~70岁为高发,平均年龄为52.3岁;单侧病变53例(86.9%),其中左肾34例(64.2%),右肾19例(35.8%),双侧病变8例(13.1%);45例(73.8%)出现腰痛,17例(27.9%)出现发热,8例(13.1%)出现血尿,2例(3.3%)出现急性肾功能衰竭;非霍奇金淋巴瘤(non-Hodgkin’s lymphoma,NHL)58例(95.1%),占绝大多数,其中B细胞淋巴瘤(B cell lymphoma,BCL)48例(82.8%),T细胞淋巴瘤(T cell lymphoma,TCL)5例(8.6%),未具体分类5例(8.6%),以弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)最常见,为28例(58.3%),霍奇金淋巴瘤(Hodgkin’s lymphoma,HL)只有1例(1.6%);47例(77.0%)接受过根治性肾切除手术,48例(78.7%)接受过化疗(其中14例为单纯化疗,34例为术后辅助化疗),9例(14.8%)接受过放疗;失访1例(1.6%),未提及预后情况3例(4.9%),34例(55.7%)病情稳定、存活,但有23例(37.7%)复发、进展,再治疗后,缓解稳定4例(6.6%),最终死亡19例(31.1%)。结论:PRL临床较罕见、易误诊、恶性程度较高、预后较差,早期行根治性肾切除术、术后联合化疗等综合治疗,有助于减少复发和改善预后。
[Abstract]:Background and purpose: primary renal lymphoma (PRL) is rare in clinic. It is difficult to diagnose before operation and is easily misdiagnosed as renal carcinoma. This study aims to summarize and explore the characteristics of clinical stage, pathological type, diagnosis and treatment and prognosis of PRL. Methods: a retrospective analysis of the clinical information of 61 cases of PRL in China from 1981 to 2014. Results: among the 61 patients, 34 (55.7%) were male and 27 (44.3%) women (1.3: 1), the age of onset was 3~84 years, the average age was high, the average age was 52.3 years old, and the unilateral lesion 53 cases (86.9%), among them left kidney 34 (64.2%), right kidney 19 cases (35.8%), bilateral lesions, low back pain Cases (13.1%) had hematuria, 2 cases (3.3%) had acute renal failure, 58 cases (95.1%) of non Hodgkin's lymphoma (non-Hodgkin 's lymphoma, NHL), of which 48 cases (82.8%) were B cell lymphoma (B cell lymphoma, BCL), T cell lymphoma (T cell) 5 cases (8.6%), and 5 cases (8.6%) were not specifically classified. (diffuse large B cell lymphoma, DLBCL) was the most common, 28 (58.3%), Hodgkin's lymphoma (Hodgkin 's lymphoma, HL) only 1 (1.6%); 47 (77%) received radical nephrectomy, 48 (78.7%) received chemotherapy (14 for simple chemotherapy, 34 for postoperative adjuvant chemotherapy), 9 (14.8%) received radiotherapy; missed 1 cases (1.6%), failed to visit (1.6%), no The prognosis was mentioned in 3 cases (4.9%), 34 cases (55.7%) were stable and survived, but 23 cases (37.7%) had recurrences and progressed. After retreatment, 4 cases (6.6%) and 19 (31.1%) died (31.1%). Conclusion: PRL is rare, easy to be misdiagnosed, high degree of malignancy, poor prognosis, early radical nephrectomy, combined chemotherapy after operation can help to reduce the disease. Less recurrence and improvement of prognosis.

【作者单位】：四川省肿瘤医院泌尿外科;
【分类号】：R737.11

【参考文献】