原发性甲状腺恶性淋巴瘤诊治分析
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杜晓辉

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Diagnosis and treatment of primary thyroid lymphoma
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    摘要:目的 提高原发性甲状腺恶性淋巴瘤的诊断与治疗水平。方法 回顾性分析1990—2005年收治的14例原发性甲状腺恶性淋巴瘤患者的临床资料。结果 12例患者以颈部肿块就诊,2例以声音嘶哑就诊,病程2周至4年。9例行患侧甲状腺全切及对侧大部分切除术,3例行双侧甲状腺全切除术,2例行患侧甲状腺及峡部切除术。术后病理诊断为弥漫性大B细胞淋巴瘤9例;滤泡性淋巴瘤4例;淋巴母细胞性淋巴瘤1例。术后联合放、化疗7例,4例行单纯局部放疗,另外3例未行辅助治疗。随访13例(92.8%),1例淋巴母细胞性淋巴瘤术后10个月死亡,2例术后未行任何治疗的患者分别于术后18,31个月死于肿瘤转移,其余10例随访6~122个月,平均43.2个月,均健在。 结论 原发性甲状腺恶性淋巴瘤临床及病理易误诊。手术是首选治疗方法,其预后与病理类型、综合治疗方案密切相关,术后辅助化疗对本病的治疗甚为重要。

    Abstract:

    Abstract:Objective To improve the diagnosis and treatment of primary thyroid lymphoma (PTL). Methods The clinical data of 14 cases of PTL treated from 1990 to 2005 were analyzed retrospectively. Results Twelve cases complained of cervical mass,and 2 cases of hoarseness, with symptoms ranging from 2 weeks to 4 years. Total thyroidectomy of affected side and partial thyroidectomy of the other side was performed in 9 cases, bilateral total thyroidectomy was performed in 3 cases, and simple total thyroidectomy of affected side was performed in 2 cases. There were 9 cases of diffuse large Bcell lymphoma, 4 cases of follicular lymphoma, and 1 case of malignant lymphoblastic lymphoma. After operation, 7 cases underwent combined treatment with radiotherapy and chemotherapy, 4 cases with simple radiotherapy, and 3 cases without any therapy after operation. Thirteen cases(92.8%) were followed up, 1 cases of lymphoblastic lymphoma died 10 months after operationa and 2 cases without postoperative therapy died of metastasis at 18 and 31 months after operation, respectively. The other 10 cases had median followup of 43.2 months(6~122 months), and all of them are in good health. Conclusions PTL is difficult to be diagnosed before operation. Surgical resection is an effective treatment for PTL. The prognostic factors of PTL are associated with pathologic type and comprehensive treatment. It is important for PTL cases to have chemotherapy after operation.

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杜晓辉,李荣,宋少柏.原发性甲状腺恶性淋巴瘤诊治分析[J].中国普通外科杂志,2007,16(1):7-.
DOI:10.7659/j. issn.1005-6947.2007.01.007

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  • 收稿日期:2006-05-30
  • 最后修改日期:2006-10-23
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  • 在线发布日期: 2007-01-25