摘要
目的:探讨原发性肝恶性淋巴瘤(primary liver lymphoma,PLL)的临床病理特点及诊治方法.方法:对我院1975-2008年收治的经病理确诊的7例原发性肝恶性淋巴瘤的病因、临床表现、形态学光镜、电镜、免疫组织化学、血清学甲胎蛋白(AFP)、乙型肝炎(HBsAg)、乳酸脱氢酶(LDH)和治疗结果进行系统分析.结果:本组7例患者,4例均上腹痛发热,3例有淋巴瘤B症状,发热、盗汗、体质量减轻.有5例合并慢性肝炎或肝硬化.组织病理学5例为B细胞表型.免疫组织化学显示CD20、CD79α阳性,电镜示瘤细胞间毛细血管、胞质细胞器发达.2例为T细胞表型,CD3、CD45RO阳性,电镜下瘤细胞质稀疏,细胞器不发达.血清学检查5例AFP和CEA阴性.5例HBsAg阳性,2例HBsAg阴性.LDH675.54U/L-1246.5U/L.4例术后采用化疗者生存时间平均为9.5mo.3例术后采用生物化疗者生存时间为23.0mo.结论:PLL与HBV病毒感染有关;伴有B症状,常见肝内占位性病变和LDH增高;首选手术切除联合生物化疗的治疗模式;能够延长患者的生存时间.
AIM： To study clinicopathological features of primary liver lymphoma （PLL） and its diagnostic as well as therapeutic methods. METHODS： Seven cases of primary liver lym- phoma, diagnosed and treated at our hospital during 1975 and 2008, were retrospectively studied. The etiology, clinical presentations, morphology （detected by light microscopy, electron microscopy, or immunohistochemistry）, serological tests of alpha fetal protein （AFP）, carcinoma embryonic antigen （CEA）, hepatitis B surface antigen （HBsAg）, and lactate dehydrogenase （LDH）, as well as therapeutic resuIts were systematically analyzed. RESULTS： Of the 7 patients, 4 patients presented with epigastric pain and fever, and 3 patients had fever, night sweats, and loss of weight. Five pa- tients were complicated with chronic hepatitis or cirrhosis. Histopathological findings showed that 5 patients were B cell phenotype with positive stain- ing of CD20 and CD79α. Electron microscopy of B cell lymphoma revealed an abundance of blood capillaries among tumor cells and organelles in cytoplasm. The other 2 patients belonged to T cell phenotype with positive expression of CD3 and CD45RO. Scant cytoplasm and few of organelles were prominent ultrastructural characteristics of T cell lymphoma. Serological test showed that 5 patients were negative for AFP and CEA, and HBsAg was positive in 5 patients. LDH level was elevated （range： 675.54 U/L-1246.5 U/L）. The longer survival time was achieved in the 3 patients treated by surgical resection plus biochemotherapy （average survival： 23 months）, compared with the 4 patients receiving surgical resection plus chemotherapy （average survival： 9.5 months）. CONCLUSION： Hepatitis B virus （HBV） infection is prevalent in PLL patients. The major clinicopathological features of PLL include B symptoms, space-occupying lesion in the liver, and elevated LDH level. Surgical resection plus biochemotherapy is a more effective approach, which prolongs survival time of PLL patients.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第9期935-939,共5页
World Chinese Journal of Digestology
关键词
肝肿瘤
恶性淋巴瘤
生物化疗
Liver neoplasm
Malignant lymphoma
Biochemotherapy
