Diffuse large B-cell lymphoma is highly heterogeneous and is diagnosed according to the 2016 World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues. The decision of treatment should be upon age, International Prognostic Index score and the tolerability of chemotherapy. High-dose chemotherapy and autologous stem cell transplantation is the standard care for relapsed, chemotherapy sensitive patients. Clinical trials are recommended in specific conditions.
Objective To improve the knowledge of pulmonary mucosa-associated lymphoid tissue (MALT)lymphoma. Methods A patient diagnosed as pulmonary MALT lymphoma was reported and related literatures were reviewed. Results The patient was a 58-year-old male,admitted due to intermittent fever,cough,sputum production,chest tightness and fatigue for 4 years.The patient was diagnosed as "pulmonary tuberculosis and tuberculous pleurisy" in other hospital and received anti-tuberculosis treatment for 3 years.The CT of the chest showed consolidation in the right middle lobe,right low lobe and left lower lobe with bronchial ventilation levy,miliary nodules in the right middle lobe,interstitial thickening,and right pleural effusion.Ultrasound guided lung biopsy pathology of the right lung showed diffuse small lymphocytes infiltration.The immunohistochemistry showed positive staining of CD20,CD79α and Vim,and weakly positive staining of Ki67(15%).Therefore,the patient was finally diagnosed pulmonary MALT lymphoma. Conclusions Pulmonary MALT lymphoma has no specific clinical manifestations,so is easy to be misdiagnosed as pulmonary tuberculosis,pneumonia or lung cancer.The patients with suspicious pulmonary MALT lymphoma should undergo percutaneous lung biopsy,transbronchial lung biopsy or open lung biopsy as soon as possible for immunohistochemistry staining to confirm the diagnosis.
【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.
【摘要】目的 分析原發性乳腺惡性淋巴瘤（primary breast lymphoma,PBL)的臨床特點、診斷和治療。方法 回顧我院2001～2004年收治的3例PBL并復習有關文獻，分析其臨床特征、診斷情況和治療方法。結果 3例均為非何杰金淋巴瘤（NHL），屬B細胞源性。PBL分期均為Ⅱ期。結論 PBL早期正確診斷，行手術、放療和化療聯合治療，效果滿意。
In recent years, the complexity of intraocular lymphoma has been gradually recognized by ophthalmologists. Although primary vitreoretinal lymphoma is the dominant type of intraocular lymphoma, ophthalmologists should be aware that it is not unique and avoid overgeneralizing specific clinical features to all intraocular lymphoma types. Intraocular lymphoma can be divided into vitreoretinal, uveal (choroid, iris, ciliary body) lymphoma according to the anatomic affected parts. According to pathological cell types, it can be divided into B cells, mantle cells, T cells and natural killer T cells. At the same time, depending on the presence or absence of extra-ocular tissue involvement, it can also be subdivided into isolated intraocular, oculo-central nervous system, oculo-system, and oculo-central nervous system lymphomas. Vitreoretinal lymphoma tends to occur in the elderly with clinical manifestations similar to uveitis and white spot syndrome and limited response to glucocorticoid therapy. The characteristic fundus manifestations include vitreous gauzy or "auroral" opacity and yellowish-white subretinal mass. Optical coherence tomography plays a key role in diagnosis and can reveal specific changes such as vertical strong reflex and intraretinal strong reflex infiltration. It is worth noting that vitreous and retinal involvement may vary, which has guiding significance for the selection of treatment strategies. In contrast, uveal lymphoma has unique clinical and pathological features, such as the chronic course of choroidal mucosa-associated lymphoid tissue (MALT) lymphoma and the equal distribution of T cells and B cells in iris lymphoma. In diagnosis, choroidal lymphoma often requires histopathological examination, and radiotherapy is the first choice for MALT lymphoma. T-cell lymphoma is similar to B-cell lymphoma in ocular fundus appearance, but diagnosis is more difficult and depends on cytopathology and T-cell receptor gene rearrangement. Comprehensive systematic screening is essential for patients with intraocular lymphoma to identify the primary site. Ocular lesions in patients with systemic lymphoma require differential diagnosis, including tumor invasion, secondary infection, and inflammatory lesions. As the incidence of lymphoma increases, ophthalmologists should constantly update their understanding of intraocular lymphoma to provide accurate diagnosis and treatment.