ObjectiveTo investigate the clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis of primary diffuse large B cell lymphoma of livers (PDLBCLL), so as to improve understanding and reasonable diagnosis and treatment of this kind of disease.MethodThe clinicopathologic data of a case of PDLBCLL diagnosed in the West China Hospital of Sichuan University in June 2019 were analyzed retrospectively.ResultsIt was very difficult to diagnose PDLBCLL preoperatively and to distinguish PDLBCLL from primary liver cancer and other liver space occupying lesions. It was also easy to ignore the possibility of invasion of liver by lymphopoietic tissue tumor, which was often diagnosed by postoperative pathological diagnosis or puncture biopsy, and after the elimination of hematological diseases by various examinations. This patient was admitted to the hospital as a space occupying in right liver. Preoperative imaging examination considered that may be a tumor. After MDT discussion, considering that the nature of the tumor should be confirmed by surgical resection, and then go to the Department of Oncology. Irregular right hemihepatectomy + cholecystectomy + hilar lymphadenectomy + diaphragmatic repair was performed after MDT discussion. The diagnosis of PDLBCLL was confirmed by postoperative pathological examination. The operation duration was about 230 min, and the intraoperative blood loss was about 200 mL. The patient recovered well without complications and was discharged on the 10th day after operation. The patient was followed up for 9 months. The liver and kidney function, electrolytes and abdominal Doppler ultrasound examination were regularly reviewed every month. No obvious abnormality was found in these results.ConclusionsAt present, there is no unified treatment principle, most of them will undergo surgery, chemotherapy, radiotherapy or combined treatment. Due to its unknown etiology and unclear mechanism, clinicians can only implement individualized treatment according to the characteristics of patients’ conditions.
Objective To assess the effectiveness and safety of autologous stem cell transplantation after high-dose chemotherapy in first-line treatment of follicular lymphoma. Method Randomized controlled trials (RCTs) of autologous stem cell transplantation after high-dose chemotherapy in first-line treatment of follicular lymphoma were collected from MEDLINE (1990-2009), EMBASE (1990-2009), OVID (1990-2009), and the Cochrane Library (Issue 2, 2009), and the proceedings of ASH were searched manually. The methodological quality of included studies was evaluated, and data analysis was performed with software STATA 10.0 and RevMan 4.3. Result A total of 4 RCTs involving 941 patients were included. The results of meta-analysis showed that overall survival rate (HR=0.82, 95%CI 0.49 to 1.15), event-free survival rate (HR=0.35, 95%CI 0.24 to 0.47), total remission rate (RR=0.35, 95%CI 0.96 to 1.30), and secondary malignant tumor incidence rate (RR=1.68, 95%CI 0.47 to 6.07). Conclusion According to the present evidences, autologous stem cell transplantation after high-dose chemotherapy can not improve overall survival rate and total remission rate, but can improve event-free survival rate, and do not increase secondary malignant tumor incidence rate. However, more high-quality, multiple-center, large-sample randomized controlled trials are required.
ObjectiveTo highlight the characteristics of pulmonary MALT lymphoma with diffuse lung disease. MethodsThe clinical,radiological and pathological data of two patients with pulmonary MALT lymphoma were analyzed,and relevant literature was reviewed. ResultsOne patient was a 59-year-old male with cough for five years while antibiotic treatment was ineffective. The chest CT scan demonstrated diffuse lung disease,bilateral multiple consolidation and ground-glass opacities,small nodules and bronchiectasis. Thoracoscopy biopsy was performed and the pathology study confirmed the diagnosis of MALT lymphoma. Another case was a 50-year-old female,who suffered from fever,cough and dyspnea. The chest CT scan revealed bilateral multiple patchy consolidation,with air bronchogram. The eosinophils count in blood was high. Diagnosed initially as eosinophilic pneumonia,she was treated with corticosteroids. The clinical symptoms were improved,but the CT scan revealed no change. After the computed tomography guided percutaneous lung biopsy,pathological examination confirmed the diagnosis of MALT lymphoma. ConclusionMALT lymphoma with diffuse lung disease is rare and easy to be misdiagnosed. The positive rate of bronchoscopy is low and percutaneous lung biopsy or thoracoscopy biopsy is more useful for diagnosis.
【摘要】 目的 總結原發性乳腺淋巴瘤（primary breast lymphoma，PBL）的臨床病理學、免疫組織化學特征、綜合治療及復發情況。 方法 對2010年11月入院手術切除的PBL術后同側乳頭復發的1例患者的臨床資料進行回顧分析，病理常規切片及免疫組織化學觀察。 結果 光學顯微鏡檢查低倍鏡下腫瘤細胞彌漫性浸潤破壞乳頭組織，導致乳頭結構紊亂，腫塊乳管結構紊亂；高倍鏡下顯示瘤細胞成分多樣，以中等大小細胞和大細胞為主，腫瘤細胞彌漫侵犯小血管。免疫組織化學結果顯示Ki-67（gt;90%），CD20（+），bcl-6（+），MUM1（+），CD43（灶+），CD3（-），CD10（-）。符合惡性非霍奇金淋巴瘤。 結論 PBL是一種少見的結外淋巴瘤，臨床表現缺乏特異性，術前很難與乳腺其他良、惡性病變區分，其診斷主要依靠術后病理。目前單純腫塊切除術+放射治療聯合全身化學療法是治療PBL臨床共識，腫瘤復發可能與Ki-67高度表達存在相關性。【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.
【摘要】 目的 探討原發性中樞神經系統淋巴瘤(PCNSL)的CT及MRI表現特征,以提高術前對該病的影像診斷能力。方法 分析2008年1月—2009年8月華西醫院16例經病理證實PCNSL患者的CT、MRI資料及病理資料。結果 病理檢查均為B細胞來源的彌漫性大B細胞性淋巴瘤。16例PCNSL 29個病灶,單發11例(69%)，多發5例(31%)18個病灶。病灶好發部位依次是大腦半球臨近蛛網膜下腔12個(41.4%)、腦室周圍深部白質7個(24.1%)、胼胝體3個(10.3%)。有5例病變CT平掃表現為等或略高于腦實質密度影,無出血和鈣化；MRI平掃75.9%(19/25)的病灶T1WI呈等低信號,T2WI等稍低信號,類似“腦膜瘤”樣信號,均未見血管流空；增強后病灶大都均勻實質團塊狀或結節狀強化,典型的可出現“尖角征”、“握拳征”,3例可見小囊變,呈“硬環征”。結論 CT對PCNSL的定性診斷作用有限,MRI具有一定特征性表現者,多可作出正確的診斷,但確診有賴于病理。