原发于肺的淋巴瘤6例并文献复习

Six Cases of Primary Pulmonary Lymphoma and Review of the Literature

目的:探讨原发于肺的淋巴瘤临床特点、诊断及治疗方法。方法:对6例原发于肺的淋巴瘤患者进行分析,结合文献对其临床特点、影像学改变、支气管镜表现、确诊手段及治疗方法进行分析。结果:原发于肺的淋巴瘤无特异性临床表现,易误诊为其它肺疾患。肺部影像学主要为单发团块或多发结节影,不易与肺癌鉴别。支气管镜下通常无异常表现或仅表现为慢性炎症,确诊主要依靠开胸手术组织病理学检查。手术切除或联合化疗是主要治疗手段。结论:原发于肺的淋巴瘤无典型临床特点,误诊率极高,支气管镜活检阳性率低,病理学检查是确定诊断的主要手段。

Objective: To study the clinical characteristics, diagnosis and treatment of primary pulmonary lymphoma. Methods: Six cases of primary pulmonary lymphoma diagnosed from 1996 to 2003 were analyzed retrospectively, and the literature was reviewed with regard to its clinical manifestations, X-ray features, bronchoscopic findings, diagnosis and treatment. Results: Primary pulmonary lymphoma was easy to be misdiagnosed to other pulmonary diseases due to lack of specific characteristics. Solitary or multiple nodules and consolidation were the main features of X-ray. But it was hard to distinguish it from lung cancer. Bronchoscopic examination could not find specific features. Definite diagnosis was depended on pathologic examinations of the lung tissue obtained through surgical operation. Treatment modalities included surgical resection and chemotherapy. Conclusions: The clinical manifestations of primary pulmonary lymphoma are nonspecific. Appropriate invasive biopsy procedures are necessary for early diagnosis.