提高原发性脾恶性淋巴瘤诊断率的探索(附7例报告)

Improvemont of the Diagnostic Rate of the Primary Malignant Lymphoma of the Spleen

报告70余例恶性淋巴瘤中7例（1％）原发性脾恶性淋巴瘤（PSL）的临床和影像学诊断的特征以及术中所见。粟粒型或微（小）结节型PSL影像诊断易漏诊（占3／7例）。凡浅表淋巴瘤容积小，未检出淋巴瘤原发病灶的巨脾患者需高度警惕PSL。PSL治疗原则上应该积极作牌切除术，再后续系统化疗。

Seven patients (10% ) of primary spleen lymphoma (PSL) among seventy cases of malignant lym-phoma in the past four years (1992. 2~1996. 8) were reported. Clinical manifestation, characteristic CT on/andultrasonography imaging and surgical confirmation were describeed. Miliary type or minor (small) nodule type ofPSL were easily missed, i, e. 3/7 cases in the series. It should be keep sighted on sma1l mass of peripheral lymphnodes, and giant spleen even without any primary focus of lymphoma. Five proposals about diagnosis were sug-gested for reference be fore PSL operation. Splenectomy should be adopted as the therapeutic principle for PSL,and then foIlowed by systemic regular chemotherapy.