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 sum up experiences in diagnosis and treatment for thyroid malignancy. Methods Clinical records of 8 patients diagnosed as Hashimoto’s disease associated with thyroid malignancy by histologic examination at our hospital from Jan. 1998 to Dec. 1998 were analyzed. Results There were 1 male and 7 females with average age of 37.6 years. The incidence of Hashimoto’s disease associated with thyroid cancer and malignant lymphoma were 7.7% and 2.6%, respectively. No operative mortality and complication was found. Conclusion Hashimoto’s disease is not uncommon. The combined thyroid cancer is small with papillary carcinoma predominance and the prognosis is good. If it is complicated with malignant lymphoma, the thyroid is rapidly enlarged with pain and dyspnea.
【摘要】 目的 总结原发性乳腺淋巴瘤（primary breast lymphoma，PBL）的临床病理学、免疫组织化学特征、综合治疗及复发情况。 方法 对2010年11月入院手术切除的PBL术后同侧乳头复发的1例患者的临床资料进行回顾分析，病理常规切片及免疫组织化学观察。 结果 光学显微镜检查低倍镜下肿瘤细胞弥漫性浸润破坏乳头组织，导致乳头结构紊乱，肿块乳管结构紊乱；高倍镜下显示瘤细胞成分多样，以中等大小细胞和大细胞为主，肿瘤细胞弥漫侵犯小血管。免疫组织化学结果显示Ki-67（gt;90%），CD20（+），bcl-6（+），MUM1（+），CD43（灶+），CD3（-），CD10（-）。符合恶性非霍奇金淋巴瘤。 结论 PBL是一种少见的结外淋巴瘤，临床表现缺乏特异性，术前很难与乳腺其他良、恶性病变区分，其诊断主要依靠术后病理。目前单纯肿块切除术+放射治疗联合全身化学疗法是治疗PBL临床共识，肿瘤复发可能与Ki-67高度表达存在相关性。【Abstract】 Objective To investigate the clinical pathology, immunohistochemical features, comprehensive treatment, recurrence and prognosis of primary breast lymphoma (PBL). Methods We retrospectively analyzed the clinical data including general information and pathological and immnohistochemical examinations of one patient with recurrent PBL in nipple of the same side after surgery who was admitted into our hospital in November 2010. Results Under low-power optical microscope lens, we found that the tumor cells diffused and infiltrated the nipple tissue which looked quite disorganized. Under high-power lens, we observed various tumor cells, especially the medium-and large-sized tumor cells which infiltrated small vessels. The results of immunohistochemical tests were as follows: Ki-67 (gt;90%), CD20 (+), bcl-6 (+), MUM1 (+), CD43 (nidus+), CD3 (-), and CD10 (-). All these indexes indicated malignant non-Hodgkin’s lymphoma. Conclusions PBL is a kind of extremely rare extra-nodal lymphoma with low-specificity clinical manifestations, and it is hard to distinguish from other mammary abnormalities. Its diagnosis mainly depends on pathological examinations. At present, lumpectomy followed by chemotherapy and radiotherapy is the best treatment method. Its recurrence may be related to the high expression of Ki-67.
目的:探讨肾脏原发性非霍奇金淋巴瘤(PNHL)的临床表现,诊治及预后特点。方法:总结我院自2000~2007年诊治的5例肾脏PNHL患者临床资料,5例患者术前均诊断为原发性肾癌。均行手术治疗,术后病理检查证实为非霍奇金淋巴瘤。 结果:拒绝化疗的患者于术后4个月死亡,一例73岁的高龄患者术后14个月死于化疗毒副反应,其余三例患者随访到现在,均无病生存。 结论:该病术前诊断困难,与原发性肾癌容易混淆,肾图对诊断该病或可提供一定参考价值。对该类肿瘤给予根治性切除,术后给予正确及时的个体化化疗可以获得较好的治疗效果,部分患者甚至可以长期无病生存。
ObjectiveTo evaluate the effects of CTX, EADM, VCR, and Pred (CHOP) as preoperative regional intra-arterial infusion chemotherapy in primary gastric malignant lymphoma (PGML). MethodsForty-one patients with PGML underwent preoperative regionalarterial infusion chemotherapy. The regimen consisting of CTX 600 mg/m2, EADM 50 mg/m2, VCR 1.4 mg/m2, and Pred 60 mg/m2, was administrated 14－21 d before operation. Another 33 patients with similar PGML during the same period underwent surgery directly. The response of the tumor and chemotherapy toxicity were observed, together with the survival of the cases. ResultsAmong the 33 patients undergoing surgery directly, 24 cases (72.7%) had curative resection, the 5-year survival rate was 58.3% (14/24). All 41 patients of the neoadjuvant chemotherapy group completed the planned regimen of chemotherapy and surgery successfully. The most common related adverse effects were grade Ⅰ-Ⅱ gastrointestinal discomfort (22 cases) and bone marrow suppression (14 cases). Thirtyseven cases (90.2%) underwent curative resection, the 5year survival rate was 67.7% (21/31). There was no significant difference between two groups in 5year survival rate (χ2=0.517， P＝0.471), while with significant difference in curative resection rate (P＝0.041). ConclusionsNeoadjuvant intra-arterial infusion chemotherapy (CHOP) has been wellrated; it appears to have improved the resectable rate of the PGML patients studied.
目的 探讨原发性脑淋巴瘤的MRI表现及病理基础，提高对脑原发性淋巴瘤的认识。 方法 回顾分析2010年1月－2012年5月28例确诊为脑原发性淋巴瘤的MRI影像特征及临床病理资料。 结果 28例患者，共发现36个病灶，幕上病灶34个，幕下病灶2个；MRI平扫；32个病灶在T1WI、T2WI肿瘤实质表现为等信号；4个病灶内出现液化坏死（其中1个病灶呈明显囊变），信号不均。MRI增强扫描：35个肿瘤病灶实质部分均匀强化，1个病灶呈环形强化。病理类型均为弥漫性大B细胞非霍奇金淋巴瘤。 结论 原发性脑淋巴瘤具有较典型的MRI影像特征，可在术前明确诊断。
目的 分析其他疾病误诊为急性阑尾炎的原因。方法 结合相关文献资料，对2004年2月至2008年12月期间本院21例其他疾病被误诊为急性阑尾炎的过程进行回顾性分析。结果 除了胆囊结石、胃穿孔、肠结核、异位妊娠等常见病可能被误诊为急性阑尾炎外，肝包虫、胆管癌、癔病、恶性淋巴瘤等也有可能被误诊为急性阑尾炎。误诊的主要原因是经治医生经验不足、思维局限、知识面狭窄，更重要的则是重视不足，检查不仔细、不全面。结论 系统和全面仔细地问诊、查体，努力提高辅助检查诊断水平等是减少误诊的关键。