原发性宫颈恶性淋巴瘤13例临床病理分析

Clinicopathologic study of thirteen patients with primary malignant lymphoma of the cervix

目的研究原发性宫颈恶性淋巴瘤的临床病理特征、治疗方法和预后。方法回顾性分析13例宫颈淋巴瘤患者的临床及病理资料。结果宫颈淋巴瘤均为非霍奇金淋巴瘤。临床症状表现为不规则阴道出血或接触性阴道出血,4例患者因宫颈息肉而发现病变。临床分期按FIG0分期标准:Ⅰ_(b1)期4例、Ⅰ_(b2)期2例、Ⅱ_a期1例,Ⅱ_b期3例、Ⅲ_b期2例,Ⅳ期1例。按Ann Arbor分期标准:Ⅰ_E期10例,Ⅱ_E期2例,Ⅳ_E期1例。6例Ⅰ_b期和1例Ⅱ_a期患者行手术治疗,5例术后接受辅助化疗或化疗加放疗,最长生存180个月。3例Ⅱ_b期、2例Ⅲ_b期、1例Ⅳ期患者行化放疗,生存期最短为6个月。结论宫颈淋巴瘤是罕见的结外型淋巴瘤,临床易误诊,联合应用组织学和免疫组织化学染色标记检查可提高宫颈淋巴瘤诊断的准确性。治疗可采用手术、化疗及放疗的综合治疗,临床分期和病理类型是预后的影响因素。

To investigate the clinicopathologic characteristics, therapy, and prognostic factors of primary malignant lymphoma of the cervix. Methods The clinical and pathological data ot 13 pahents with primany malignant lymphoma of the cervix were analyzed retrospectively. Results Thirteen patients all were non-Hodgkin＇s lymphoma. They presented with symptoms of abnormal vaginal bleeding or postcoital spotting, four patients presented with cervical polyp. Accrding to FIGO stage syetem, four patient had stage Ibl disease, 2 had stage Ib2 disease, 1 had stage Ⅱ a disease, 3 had stage Ⅱb disease, 2 had stage Ⅲ b disease, and 1 had stage IV disease. Six patients with stage Ib disease and 1 patient with stage Ⅱ a disease underwent operation. Five patients underwent postoperative chemotherapy, with or without radiotherapy, the longest survival period was 180 months. Six patients underwent chemotherapyand radiotherapy, the shortest survival period was 6 months. Conclusions The lymphoma of the cervix is a rare and commonly misdiagnozed entity of extranodal lymphoma Immunohistochemieal analysis using several kinds of markers is helpful in establishing the correct diagnosis in addition to focusing on character- istic histopathological features. It is necessary to take comprehensive treatment including surgery, chemotherapy and radiotherapy for patients with lymphoma of the cervix, chemotherapy may play the important role in the treatment. The prognostic factors of survival include clinical stages and histopathologieal types.