目的:探討腎臟原發性非霍奇金淋巴瘤(PNHL)的臨床表現,診治及預后特點。方法:總結我院自2000~2007年診治的5例腎臟PNHL患者臨床資料,5例患者術前均診斷為原發性腎癌。均行手術治療,術后病理檢查證實為非霍奇金淋巴瘤。 結果:拒絕化療的患者于術后4個月死亡,一例73歲的高齡患者術后14個月死于化療毒副反應,其余三例患者隨訪到現在,均無病生存。 結論:該病術前診斷困難,與原發性腎癌容易混淆,腎圖對診斷該病或可提供一定參考價值。對該類腫瘤給予根治性切除,術后給予正確及時的個體化化療可以獲得較好的治療效果,部分患者甚至可以長期無病生存。
Objective To observe the ocular features and analyze the cause of misdiagnosis of intraocular nonHodgkin's lymphoma (IONHL). Methods A retrospective study was performed in 6 patients and related literatures were reviewed. The age of those patients was 46 to 68 yrs with an average of 562 yrs. Four cases were female, two cases were male. Five patients were unilateral and one case was bilateral case. All patients were investigated by Goldmann tonometer, fundus fluorescein angiography (FFA) and ophthalmic Bscan. Pathological samples come from enucleation and vitrectomy, and were analyzed histologically and immunohistochemically. Results Ophthalmological signs of IONHL included decrease visual acuity, red eye, aqueous flare; keratic precipitates (Kp), vitreous opacity, retinal detachment and multiple whiteyellow retinal lesions of different sizes and fuzzy boundaries. IONHL patients were always misdiagnosed as diverse and nonspecific symptoms and signs, two cases were misdiagnosed as retinitis or chorioiditis, one case as intermediate uveitis, one case as secondary glaucoma in uveitis. The duration from onset of symptom and sign to a final diagnosis was from 6 months to 24 months with an average of 13.3 months. Conclusions The clinical manifestation of IONHL was diverse and non-specific，and this disease was unknown to lots of doctors and easily be misdiagnosed.
ObjectiveTo analyze the disease burden and development trend of non-Hodgkin lymphoma (NHL) in China from 1990 to 2019. MethodsThe changes of incidence, mortality, disability-adjusted life years (DALY) and their corresponding age-normalization rates for NHL were analyzed by using the 2019 Global Burden of Disease Database. Regression analysis was performed by Joinpoint software to calculate annual percentage change (APC) and average annual percentage change (AAPC) of standardized morbidity, standardized mortality, standardized DALY rate to reflect the change trend of disease burden. And the results were compared with global data. ResultsFrom 1990 to 2019, the disease burden of NHL in China showed an overall increasing trend. Compared with 2019, the standard incidence rate, standard mortality rate and standard DALY rate of NHL in China increased by 144.72%, 27.17% and 15.61%, respectively. The annual rates of change were 3.12%, 0.80% and 0.51%, respectively. There were gender and age differences in disease burden. The burden of disease increased with age, and the burden of disease was higher in males than in females. ConclusionThe disease burden of NHL in China shows an increasing trend from 1990 to 2019. With the development of diagnosis and treatment options, the disease burden has decreased in recent years, but it is still higher than the global level. There is still a need to strengthen research on its pathogenesis and treatment options, and to actively intervene in high-risk groups to reduce the disease burden of NHL.
目的：分析口咽部B細胞來源非霍奇金淋巴瘤(NHL)的CT表現、特征，初步探討不同病理類型B細胞來源NHL的CT表現特點，為臨床診斷和治療提供更為準確的信息。方法：對18例經病理證實的口咽部B細胞來源非霍奇金淋巴瘤的CT表現進行回顧性分析。結果：18例中，彌漫大B細胞淋巴瘤13例，占72.2%(13/18)，濾泡性淋巴瘤3例，占16.7%(3/18)，套細胞淋巴瘤1例，占5.6%(1/18)，結外邊緣區淋巴瘤(MALT淋巴瘤)1例，占5.6%(1/18)。病變分布為：扁桃體NHL9例(彌漫大B細胞淋巴瘤8例、套細胞淋巴瘤1例)；舌根8例(彌漫大B細胞淋巴瘤5例、濾泡性淋巴瘤3例)；軟腭1例，為結外邊緣區淋巴瘤(MALT淋巴瘤)。18例病變均表現為腫塊型。同時有淋巴結受累者12例(66.7%)，其中雙側受累者3例。結論：口咽B細胞來源NHL多發生于扁桃體及舌根。病理類型以彌漫大B細胞淋巴瘤為主，主要表現為腫塊。 CT對于B細胞來源NHL的鑒別診斷和病變范圍的判斷具有重要作用。
【摘要】 目的 探討對自體造血干細胞移植（autologous hematopoietic stem cell transplantation，auto-HSCT）后復發的非霍奇金淋巴瘤患者再進行異基因造血干細胞移植（allogeneic hematopoietic stem cell transplantation，allo-HSCT）治療的臨床療效。 方法 收集2000年1月-2010年12月難治性惡性淋巴瘤采用auto-HSCT后復發患者11例，病程27個月~6.5年。所有患者在auto-HSCT前均為復發難治性病例，auto-HSCT后，完全緩解8例，部分緩解3例，自體移植后中位復發時間15個月，患者復發后采用異基因親緣造血干細胞移植，人類白細胞抗原（human leukocyte antigen，HLA）全相合（6/6）6例，5/6相合3例，4/6相合2例；性別相同6例，性別不同5例。預處理方案為FBC方案，即氟達拉濱30 mg/m2 1~5 d，白消安12~14 mg/kg分4 d口服，環磷酰胺120 mg/kg分2 d使用。移植物均為外周血造血干細胞加骨髓。移植物抗宿主病（graft-versus-host disease，GVHD）的預防：HLA全相合采用環孢素+短程甲氨蝶呤+嗎替麥考酚酯，不全相合采用抗胸腺細胞球蛋白+環孢素+短程甲氨蝶呤+嗎替麥考酚酯。 結果 11例患者全部獲得造血重建，急性GVHD發生6例（54.55%），其中Ⅰ度、Ⅱ度4例，Ⅲ度、Ⅳ度各1例；1例Ⅳ度GVHD因合并感染死亡，5例均得到有效控制；發生慢性GVHD 7例（63.64%），其中有2例急性GVHD轉為慢性，4例局限型，3例廣泛型。隨訪8個月~9年，有4例分別于移植后8、15、21、34個月疾病復發，另外6例仍生存。 結論 allo-HSCT對于auto-HSCT后復發的非霍奇金淋巴瘤患者仍是一種有效的挽救性治療手段。【Abstract】 Objective To explore the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on relapsing non-Hodgkin′s lymphoma after autologous stem cell transplantation (auto-HSCT). Methods The clinical data of 11 patients with recurrent non-Hodgkin′s lymphoma after auto-HSCT from January 2000 to December 2010 were collected, including nine males and 2 females with the median age of 39 years (13-48 years old), and the median duration of the disease was 3 years (27 months-6.5 years). All patients were relapsed or refractory cases. After auto-HSCT, complete remission was found in 8 and partial remission was in 3. The recurrence median time after auto-HSCT was 15 months. The patients underwent allo-HSCT after the recurrence of the disease. In the 11 patients, human leukocyte antigen (HLA) full matched (6/6) in 6, 5/6 matched in 3, and 4/6 matched in 2; the same gender in 6 and different gender in 5. FBC conditioning regimen: fludarabine 30 mg/m2 for 1-5 days, BU 12-14 mg/kg in 4 days of oral, CY 120 mg/kg in 2 days. Grafts are peripheral blood stem cells plus bone marrow. Prevention of graft-versus-host disease (GVHD): HLA full-matched by CsA+short-term MTX+MMF and mismatched by ATG+CsA+short-term MTX+MMF. Results All of the 11 patients received hematopoietic reconstruction, acute GVHD occurred in 6 cases (54.55%), including degree Ⅰ plus Ⅱ in 4, degree Ⅲ in 1 and degree Ⅳ in 1. One patient died of infection due to degree Ⅳ GVHD, and the rest had been effectively controlled. Chronic GVHD occurred in 7 patients (63.64%); limited type was in 4 in and extensive type was in 3. During the follow-up period of 8 months-9 years, 4 patients relapsed 8, 15, 21, and 34 months after transplantation, and the other 6 patients was still alive. Conclusion Allo-HSCT is effective on relapsing non-Hodgkin′s lymphoma after auto-HSCT.