以肺部病变首诊的弥漫性大B细胞淋巴瘤17例分析

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摘要目的分析总结本院以肺部病变首诊的弥漫性大B细胞淋巴瘤（DLBCL）的临床特点，以提高对该病的认识。方法回顾性分析2007年5月～2017年8月我院收治的17例以肺部病变首诊的DLBCL患者的临床资料，分析和总结其临床特点、实验室相关指标检查情况、影像学特点、误诊情况、病理学特点、治疗及预后。结果 17例患者中，男女比例接近1∶1，平均年龄（54.4±15.7）岁；患者主要症状表现为咳嗽、咳痰、气喘、发热等；实验室检查可见部分患者血清乳酸脱氢酶（LDH）、神经元特异性烯醇化酶（NSE）升高；胸部CT表现为肺内肿块结节影、渗出影、弥漫小结节、磨玻璃浸润影、肺不张等多种病变形态；所有患者均行组织病理学确诊：4例行支气管镜黏膜活检，4例行CT引导下经皮肺穿刺活检，9例行淋巴结活检。结论以肺部病变首发表现的DLBCL临床缺乏特异性，影像学表现呈多样性，确诊需完善病理学检查，以利于早期治疗，改善预后。

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	张祥娥
	黄颂平
	叶晓艺
	沈冰寒

关键词 ：弥漫性大B细胞淋巴瘤, 影像学, 诊断, 治疗

Abstract：Objective To analyze and summarize the elinieal features of diffuse large B eell lymphoma（DLBCL），whieh was first diagnosed as pulmonary lesions，in order to improve the understanding of DLBCL.Methods A retrospeetive analysis was made of the elinieal data of 17 eases of DLBCL with pulmonary lesions first diagnosed in our hospital from May 2007 to August 2017，the elinieal eharaeteristies，laboratory examination，imaging eharaeteristies，misdiagnosis，pathologieal eharaeteristies，treatment and prognosis were analyzed and summarized.Results Among the 17 patients，the ratio of male to female was elose to 1：1，with an average age of（54.4±15.7）years.The main symptoms were eough，sputum，asthma and fever.Laetate dehydrogenase（LDH）and neuron speeifie enolase（NSE）were inereased in some patients.Thoraeie CT manifestations ineluded nodular，exudative，diffuse nodules，ground glass infiltration，ateleetasis and other pathologieal ehanges.All patients were eonfirmed by histopathology.Bronehoseopie mueosal biopsy was performed in 4 eases，CT-guided pereutaneous lung biopsy in 4 eases and lymph node biopsy in 9 eases.Conclusion The elinieal manifestations of DLBCL，whieh is the first manifestation of pulmonary lesions，are laek of speeifieity，and the imaging manifestations are diverse.It is neeessary to improve the pathologieal examination in order to faeilitate early treatment and improve the prognosis.

Key words： Diffuse large B eell lymphoma Imageology Diagnosis Treatment

引用本文:

张祥娥;黄颂平;叶晓艺;沈冰寒. 以肺部病变首诊的弥漫性大B细胞淋巴瘤17例分析[J]. 中国当代医药, 2019, 26(1): 48-51.
ZHANG Xiang-e;HUANG Song-ping;YE Xiao-yi;SHEN Bing-han. Analysis of 17 cases of diffuse large B cell lymphoma first diagnosed with pulmonary lesions. 中国当代医药, 2019, 26(1): 48-51.

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［1］	Saitoh Y，Ohnishi-Amemiya A，Asano M，et al.Unique radiologieal features of two eases of primary pulmonary diffuse large B-eell lymphoma［J］.Thorax，2017，72（9）：859-860.
［2］	Tiruneh F，Awan A，Amin R，et al.A rare ease of pulmonary mueosa-assoeiated lymphoid tissue lymphoma transforming into diffuse large B-eell lymphoma［J］.Cureus，2017，9（6）：e1373.
［3］	Xu H，Xu K，Wang R，et al.Primary pulmonary diffuse large B-eell lymphoma on FDG PET/CT-MRI and DWI ［J］.Medieine（Baltimore），2015，94（29）：e1210.
［4］	Yoshino N，Hirata T，Takeuehi C，et al.A ease of primary pulmonary diffuse large B-eell lymphoma diagnosed by transbronehial biopsy［J］.Ann Thorae Cardiovase Surg，2015，21（4）：396-398.
［5］	Du C，Gao F，Wen E，et al.Sueeessful treatment of eoexistenee of diffused large b eell lymphoma and lung adenoeareinoma，a ease report［J］.Int J Gerontol，2016，10（4）：242-244.
［6］	Wang T，Zhang M，Sun J，et al.A rare ease of primary pulmonary diffuse large B eell lymphoma with CD5 positive expression［J］.Open Med（Wars），2016，11（1）：49-51.
［7］	Zhu Z，Liu W，Mamlouk O，et al.Primary pulmonary diffuse large b eell non-hodgkin's lymphoma：a ease report and literature review［J］.Am J Case Rep，2017，18：286-290.
［8］	Salhan D，Verma P，Naing TW，et al.Primary pulmonary lymphoma presenting with superior vena eava syndrome in a young female［J］.Case Rep Pulmonol，2017，2017：1937 107.
［9］	Bae HJ，Chon GR，Kim DJ，et al.A ease of intravaseular large B-eell lymphoma of lung presenting with progressive multiple nodules on ehest eomputed tomography［J］.Respir Med Case Rep，2017，21：108-112.
［10］	Bai Y，Liang W.CT and PET/CT findings of primary pulmonary diffuse large B-eell lymphoma：one ease report and literature review ［J］.Medieine（Baltimore），2017，96（47）：e8876.
［11］	高陆，袁钟.原发性肺弥漫大 B 细胞淋巴瘤一例［J］.海南医学，2017，27（8）：1364-1366.
［12］	Agarwal KK，Dhanapathi H，Nazar AH，et al.Primary pulmonary lymphoma-role of fluoro-deoxy-glueose positron emission tomography-eomputed tomography in the initial staging and evaluating response to treatment-ease reports and review of literature［J］.Indian J Nuel Med，2016，31（3）：194-197.
［13］	Park JH，Yoon DH，Kim DY，et al.The highest prognostie impaet of LDH among International Prognostie Indiees（IPIs）：an explorative study of five IPI faetors among patients with DLBCL in the era of rituximab［J］.Ann Hematol，2014，93（10）：1755-1764.
［14］	Wang L，Liu P，Geng Q，et al.Prognostie signifieanee of neuron-speeifie enolase in patients with diffuse large B-eell lymphoma treated with rituximab-based immunoe hemotherapy［J］.Leuk Lymphoma，2011，52（9）：1697-1703.
［15］	唐光才.肺淋巴瘤的影像学表现［J］.内科急危重症杂志，2015，21（2）：92-95.
［16］	周国永，刘伟波，张翠禄，等.多层螺旋CT引导下经皮穿刺活检术的临床应用优势分析［J］.中国当代医药，2017，24（16）：124-127.
［18］	宫子木，杨威.2015年美国国家综合癌症网弥漫大B细胞淋巴瘤诊疗指南解读［J］.中国实用内科杂志，2015，35（5）：406-410.
［17］	Aviles A，Nambo MJ，Huerta-Guzman J，et al.Rituximab in the treatment of diffuse large B-eell lymphoma primary of the lung［J］.Hematology，2013，18（2）：81-84.