心脏继发性淋巴瘤65例临床分析

Clinical Analysis of 65 Patients with Secondary Lymphoma of Heart

目的 分析心脏继发性淋巴瘤 (SLH)的临床特征、治疗效果和预后因素 ,提高诊治水平。方法 回顾性分析 6 5例SLH的临床表现、病理类型、治疗疗效及预后因素。结果 初诊时表现为浅表淋巴结肿大的 17例 (2 6 .2 % ) ,纵隔淋巴结肿大 35例 (5 3.8% )。 5 4例 (83.1% )临床分析为Ⅳ期 ,心功能Ⅲ或Ⅳ级占 2 2例 (33.8% )。弥漫大B细胞性淋巴瘤、弥漫性小淋巴细胞性淋巴瘤、T淋巴母细胞性淋巴瘤和结节硬化型霍奇金淋巴瘤共占 4 7例 (72 .3% )。非霍奇金淋巴瘤 (NHL)和霍奇金淋巴瘤 (HL)的有效率分别为 6 3.2 %和 10 0 % ,中位生存期分别为 18个月和 4 7个月。结论 浅表或纵隔淋巴结肿大为SLH最常见症状 ,多数患者为晚期 ,多因素分析表明心功能分级 (P =0 .0 13)和治疗效果 (P =0 .0 0 6 )

Objective To analyze the clinical characteristics,therapeutic outcomes and prognostic factors of secondary lymphoma of heart (SLH).Methods A retrospective study was performed to analyze the clinical manifestation,pathological types,therapeutic outcomes and prognostic factors of 65 patients with SLH.Results Enlarged superficial or mediastinal lymph nodes are the most frequent initial symptoms,accounting for 30.8% (20 patients) and 53.9% (35 patients) respectively.At the initial diagnosis, 54 ( 83.1% ) patients were in clinical stage Ⅳ and 22 ( 33.8% ) patients presented with the grading Ⅲ or Ⅳ of heart function. Small lymphocytic lymphoma, diffuse Iarge B cell lymphoma, T cell lympoblastic lymphoma and Hodgkin's lymphoma nodular sclerosis type account for 47 patients ( 72.3% ). The treatment response rates of Non Hodgkin's lymphoma and Hodgkin's lymphoma are 63.2% and 100% respectivedly, the median survival are 18 months and 47 months respectively. Conclusion Enlarged lymph nodes are the most frequent initial symptoms.Majority of patients are in the advanced stage. Multivariate analysis showed grading of heart function ( P = 0.013 ) and therapeutic results ( P = 0.006 ) were independent prognostic factors.