【摘要】 目的 探討原發性胰腺淋巴瘤( PPL) 的臨床特點及治療方法。方法 回顧性分析我院2002～2006年期間收治的6 例PPL 的臨床資料。結果 本組6 例患者中3 例病灶位于胰頭,3 例位于胰體尾。臨床癥狀以上腹不適、黃疸為主。術前僅1 例通過影像學檢查獲得診斷。2 例行胰十二指腸切除術,3 例行胰體尾聯合脾切除術,1 例行剖腹探查、組織活檢術。術后病理診斷均為胰腺非霍奇金淋巴瘤。患者術后均行化療,除1 例失訪以外,其余5 例均存活。結論 PPL 的臨床癥狀、影像學表現及實驗室檢查結果不具特異性,與胰腺癌難以區分,明確診斷有賴于病理組織學檢查。對術前未能確診的胰腺淋巴瘤患者,外科手術治療結合術后化療、放療安全有效。
Objective To investigate the relevance of primary pulmonary non-Hodgkin’s lymphoma ( PPNHL) imaging with pathology features, so as to improve the diagnostic accuracy. Methods Twenty-two patients of PPNHL were scanned by chest computed tomography, and the results of clinical and pathology features were analyzed. Results The resulting pathologic examination showed that all patients in 12 cases of low-grade lymphoma had MALT lymphoma( 54. 5% ) , histologically with slightly atypical small lymphocyte proliferated. The radiological findings indicated unilateral peripheral lesion which extended along mucous membrane in 11 patients ( 91. 7% ) and multilateral lesion in only 1 patients ( 8. 3% ) . CT features were illdefined nodule or mass with halo sign ( n =8, 66. 7%) , patchy infiltrate ( n = 4, 33. 3% ) , and ill-defined consolidations with air-bronchograms ( n =7, 58. 3% ) . The resulting pathologic examination showed that 10 patients were high and middle-grade lymphoma ( 45. 5% ) . The radiological findings indicated unilateral lesion in4 patients ( 40%) and multilateral lesion in 6 patients( 60% ) . CT features were ill-defined noduleor mass ( n =4, 40% ) , patchy infiltrate ( n = 1, 10% ) , mixed manifestation ( n =5, 50% ) , pleural effusion ( n =5, 50% ) , hilar and mediastinal lymph node enlargement ( n =2, 20% ) , atelectasis ( n =3, 30%) , and pulmonary interstitial with interlobular septal thickening ( n=2, 20% ) . Conclusions The imaging features of PPNHL rely on its’ basic pathology. Low-grade lymphoma is characterized by peripheral focal consolidation with air-bronchograms. High and middle-grade lymphoma is characterized by mixed manifestation of interstitial change and nodular focus. Analyzing CT features seriously may be helpful for diagnosis of PPNHL.
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.