【摘要】 目的 探討乳腺惡性淋巴瘤的臨床病理特征、治療方式及其與預后關系。 方法 1980年1月-2007年12月對收治的21例乳腺惡性淋巴瘤患者的臨床病理特點、診斷和治療方法進行回顧性分析。 結果 21例乳腺惡性淋巴瘤患者均為女性，中位年齡47歲；其中原發性乳腺惡性淋巴瘤18例，繼發性惡性淋巴瘤3例。原發性乳腺惡性淋巴瘤均為非霍奇金淋巴瘤，B細胞來源為主，大多為術后診斷，治療均采用手術+化學療法。 結論 乳腺惡性淋巴瘤治療應強調手術，化學療法和放射治療的綜合治療。【Abstract】 Objective To study the clinico-pathological features and treatment modality of malignant breast lymphoma, and their relationships with the prognosis of the disease. Methods The clinico-pathological features, diagnosis and treatment methods of 21 cases of malignant breast lymphoma diagnosed between January 1980 and December 2007 were analyzed retrospectively and related domestic and overseas literature was reviewed. Results Among the 21 female patients, 18 had primary breast lymphoma (PBL), 3 had secondary breast lymphoma. All cases of PBL were non-Hodgkin’s lymphoma with mainly B cells as the origin. The median age of the patients was 46.5 years old. Most of the cases were diagnosed postoperatively and all patients were treated by operation combined with chemotherapy. Related literature reviewing showed that clinical staging and treatment modality were important factors of prognosis. Conclusion In treating malignant breast lymphoma, operation and chemoradiotherapy should be combined together to get a better result.
ObjectiveTo analyze the characteristics of ultrasound images for soft tissue lymphoma and discuss the diagnostic value of ultrasonography.
MethodsBetween January 2008 and August 2014, the ultrasound images of 25 soft tissue lymphomas confirmed by histopathology and immunohistochemistry were retrospectively analyzed.
ResultsOf the total 25 patients with soft tissue lymphoma (histological types of non-Hodgkin's lymphoma), there were 10 females and 15 males. Among them, 14 had diffuse large B-cell lymphoma (56%, 14/25). There was a primary lymphoma located in the lower leg, and all the rest 24 cases were secondary lymphoma. Of the 24 secondary cases, 19 presented solitary lesion located respectively in limbs (8 cases), trunk (7 cases) and head & neck (4 cases); the other 5 cases presented multiple lesions located respectively in limbs and trunk. Among all the lesions, 12 were located in muscular layer, presenting weak echo mass with irregular shape growing along the direction of muscular fibers; and 13 were located in skin and subcutaneous soft tissue, among which 4 cases showed diffused thickening of skin and subcutaneous layer with irregular hypoechoic areas on ultrasound examination, and 9 cases showed nodular or hypoechoic irregular shaped lesion, iso-hyperechoic, with heterogeneous internal echogenecity having unclear boundary.
ConclusionUnderstanding the characteristics of soft tissue lymphoma on ultrasound images will help to improve diagnostic accuracy.
Objective
To investigate ultrasonography features of primary thyroid non-Hodgkin lymphoma (PT-NHL).
Methods
Ultrasonographic data of patients with PT-NHL(PT-NHL group) and non-Hodgkin lymphoma (control group) who were treated in our hospital from May. 2002 to Jul. 2014 were collected and analyzed.
Results
Compared with control group, enhancement of posterior echoes was more common in PT-NHL group (P=0.000), and difference values of transverse diameters, anteroposterior diameters, and sagittal diameters of more involved lobe to another lobe were bigger(P < 0.05), but echo pattern of gland, ultrasonographic classification of lesions, classification of vascularity, and condition of cervical lymph nodes were found no statistical difference(P > 0.05). In patients with nodular-type lesions(37 patients in PT-NHL group and 12 patients in control group), length of nodule lesions was larger in PT-NHL group (P=0.000), but there was no statistical difference in shape, boundary, orientation, and echoes of nodules between 2 groups(P > 0.05). In Pulsed-Wave(PW) Doppler between 2 groups(17 patients in PT-NHL group and 4 patients in control group), vascular resistance index(RI) was higher in PT-NHL group than those of control group (P=0.024).
Conclusion
The enhancement of posterior echoes was a feature in ultrasonography images of PT-NHL. Asymmetrical volume, high value of RI, and big nodule might link to PT-NHL, but diffuse heterogeneous echo with hypoechoic lesions might result in wrong diagnosis as PT-NHL.
From 1987 to 1993, 12 cases of primary gastric malignant lymphoma (PGML) were hospitalized. The incidence of PGML was 1.9% of gastric malignancies during the same period. There were 5 cases in stage Ⅰ, 4 in stage Ⅱ, 1 in stage Ⅲ, and 2 in stage Ⅳ. The preoperative diagnosis of PGML was difficult because the incidence of PGML is low, the symptoms are nonspecific, and the radiologic and fibrogastroscopic character were very similar to those of gastric carcinoma and peptic ulcer disease. The surgical treatment of PGML is disccused.
ObjectiveTo summarize the individualized diagnosis and treatment experience in a patient with primary pancreatic diffuse large B-cell lymphoma.MethodsBy muti-disciplinary term (MDT) model, a patient with primary pancreatic diffuse large B-cell lymphoma admitted in the People’s Hospital of Chishui in Dec. 2016 was discussed. The diagnosis, perioperative period management, and operation scheme were carried out by the MDT.ResultsThe patient’s general condition was good. After multidisciplinary discussion in the Department of Radiology, Oncology, Interventional, and Hepatobiliary and Pancreatic Surgery, the patient was considered to have surgical indications. After thorough communication with the patient and family, the patient was selected for surgical resection. The whole operation lasted for 5 hours, and the intraoperative blood loss was about 300 mL. The operation was successfully completed and no complications such as pancreatic fistula occurred after operation. Liquid drainage tube was drawn out at 10 days after opertion, and pancreatic tube stent and T tube were retained. The patient discharged on 13 days after surgery. Subsequently, the patient underwent adjuvant chemotherapy. At present, the patient has been followed up for 1 year, no signs of tumor recurrence and metastasis, and continued follow-up.ConclusionsPrimary pancreatic diffuse large B-cell lymphoma is rare and has a poor prognosis. The main treatment is mutli-mode treatment based on surgical resection combined with chemotherapy.
