原发性肾上腺恶性淋巴瘤3例报告

Primary adrenal lymphoma: Report of 3 cases

目的:提高临床对原发性肾上腺恶性淋巴瘤(PAL)的诊治水平。方法:报告收治的3例PAL患者的临床资料,3例的临床表现和影像学检查均无特异性。2例经手术探查明确诊断,1例在CT导引下行肿瘤穿刺活检后明确诊断。病理检查均诊为弥漫型、大B细胞性肾上腺非霍奇金PAL,术后均常规行CHOP化疗。结果:1例患者随访1年后失访,另2例分别于诊断后1年8个月、5年2个月死亡。结论:PAL恶性度较高,预后不良,临床表现和影像学检查缺乏特异性,CT或超声导引下的活检穿刺是明确诊断的好方法,手术及化疗对PAL有效。

Objective：To elevate the level of diagnosis and treatment of primary adrenal malignant lymphoma （PAL）. Methods：The clinical data of 3 PAL patients in our department was reviewed, 2 male and 1 female, 45 to 63 years old. There were no special features either in clinical manifestations or in conventional imaging studies. The final pathologic diagnosis was achieved by surgical exploration （2 cases） and needle puncture directed by com- puted tomography （CT） （1 case）. Pathological diagnosis was non-Hodgkin lymphoma with diffuse and big B-cell microscopically. After surgery, they underwent a combined polychemotherapy （cyclophospamide, adriamycin, vincristine and prednisone） （CHOP regime）. Results ： One patient is missed and the others died 20 months and 62 months after diagnosis respectively. Conclusions： The present cases indicated that primary adrenal lymphoma was relatively malignant with poor prognosis. Clinical manifestations and conventional imaging studies demonstrated no special characteristics compared with benign adrenal tumor. We suggest that it＇s a good idea to take a puncture directed by CT or sonography. Adrenal operation and chemotherapy is relatively efficacy.