摘要
目的探讨原发性肝淋巴瘤（PHL）的临床诊断、治疗及预后。方法回顾性分析2008年3月至2015年12月中山大学附属第三医院收治的9例PHL患者临床资料。其中男6例,女3例;年龄46~61岁,中位年龄53岁。患者均签署知情同意书,符合医学伦理学规定。分析其临床表现、诊断经过、治疗方案及预后。结果 9例患者中,4例因发现肝占位性病变就诊,3例上腹痛,2例伴发热;9例合并慢性乙型病毒性肝炎（乙肝）。3例术前血清乳酸脱氢酶升高。超声检查表现为肝内低回声实质光团,CT平扫显示肝内低密度病灶。9例患者均经病理学检查确诊。2例行单纯手术切除,2例行手术＋化疗,5例行肝穿刺活检＋化疗。截止至投稿日期,存活6例,其中生存时间超过12个月者4例。结论 PHL临床及影像学表现无特异性,确诊需依靠病理学检查,手术切除联合化疗是有效的治疗方法。
Objective To investigate the clinical diagnosis,treatment and prognosis of primary hepatic lymphoma（PHL）.Methods Clinical data of 9 patients with PHL who admitted and treated in the Third Affiliated Hospital of Sun Yat-sen University between March 2008 and December 2015 were retrospectively analyzed.Among the patients,6 were males and 3 were females with the age ranging from 46 to 61 years old and the median of 53 years old.The informed consents of all patients were obtained and the local ethical committee approval was received.The clinical manifestation,diagnosis procedure,therapeutic regimen and prognosis of the patients were analyzed.Results Among the 9 patients,4 cases saw the doctor for the finding of a hepatic space-occupying lesion,3 cases for epigastric pain,and 2 cases for fever.Nine cases were complicated with chronic viral hepatitis B（HBV）.Elevated preoperative serum lactate dehydrogenase was observed in 3 cases.Ultrasound examination indicated a hypoechoic echogenic mass in the liver,and plain CT scan indicated a low-density lesion in the liver.The diagnosis of all 9 patients was confirmed by the pathological examination.Two cases underwent simple resection,2 underwent resection ＋ chemotherapy and 5 underwent liver biopsy ＋ chemotherapy.By the papersubmission date,6 patients survived and 4 of them survived more than 12 months.Conclusions The clinical manifestation and imaging findings of PHL are non-specific.Confirmed diagnosis depends on the pathological examination,and surgical resection combined with chemotherapy is an effective treatment.
出处
《中华肝脏外科手术学电子杂志》
CAS
2016年第3期173-176,共4页
Chinese Journal of Hepatic Surgery(Electronic Edition)
基金
广东省自然科学基金(2015A030310126)
关键词
肝肿瘤
淋巴瘤
诊断
化学疗法
辅助
Liver neoplasms
Lymphoma
Diagnosis
Chemotherapy
adjuvant
