原发性肾上腺非霍奇金淋巴瘤(附2例报告并文献复习)

Primary adrenal lymphoma:two cases report

目的:探讨原发性肾上腺恶性淋巴瘤的临床特征。方法:报告2例本病患临床资料。2例临床及影像学上均无特异性。CT示不规则肿块,伴血清乳酸脱氢酶和β2微球蛋白升高。组织学上瘤细胞呈弥漫分布,多呈圆形或卵圆形,核分裂像易见。免疫组化CD3、CD45-RO、L26、CD79a阳性。手术切除肿瘤后均正规联合化疗4个疗程。结果:2例患者随访半年,均健在。结论:原发性肾上腺恶性淋巴瘤恶性度较高,预后差,影像学和酶学检查可提示本病可能,可进一步行骨髓穿刺及经皮针吸活检术以明确诊断。治疗上主要是手术加联合化疗。

Objective： To describe the clinical features of primary adrenal lymphoma（PAL）. Methods： Clinical data were discussed in two cases of PAL. The presenting symptoms and imaging modalities were nonspecific. Computed tomography（CT） scan of the abdomen revealed irregular adrenal mass lesions with elevated serum lactate dehydrogenase and 132 microglobulin. Histologically, the tumor cells showed a round or oval shape, forming the structures of diffuse sheet. The neoplastic cells showed frequent mitosis. Immunohistochemically, the tumor cells were positive for CD3,CD45-RO, L26 and CD79a. Two cases were given four cycles of based combination chemotherapy after tumorectomy. Results： At six-month follow-up two patients have no evidence of diease. Conclusions： PAL is extremely rare tumor with a high grade of malignancy and poor prognosis. A provisional diagnosis of PAL is made on the basis of the presence of imageology and enzymology, which can be subsequently substantiated by bone marrow aspiration and percutaneous fine needle aspiration biopsy. The principal treatment consisted of adrenalectomy and adjuvant combination chemotherapy.