原发性肝恶性淋巴瘤1例报告(附文献复习)

PRIMARY LYMPHOMA OF THE LIVER—A CASE REPORT AND REVIEW

目的探讨原发性肝恶性淋巴瘤（ＰＬＬ）影响预后因素及治疗方法。方法收治１例ＰＬＬ治疗情况并复习国内外有关ＰＬＬ治疗病例３８例，合计３９例。分析ＰＬＬ预后因素及治疗结果。结果１．孤立性病灶治疗方式有手术局部切除（１０例），放射治疗（２例）和联合化疗（３例）。局部复发２例（手术１例，放射１例，剂量８Ｇｙ），死亡３例。多发病灶治疗方式有：联合化疗（１７例），放射治疗（３例）和未治疗（４例）。治疗病例中，局部复发７例（化疗６例，放射１例，剂量２１Ｇｙ。死亡１０例。２．有Ｂ症状者（１２例）死亡９例（７５％），无Ｂ症状者（２７例）死亡（３例）（１１．１％）（Ｐ＜０．０１）。结论有Ｂ症状者、肝内病灶多发者预后差；孤立性病灶者，无论手术、放射或／和化疗都有较好的局部控制。肝内多发病灶者，单纯全身化疗局部复发率高。

おURPOSE To analyse the prognosis and results of PLL treated by various modalities.METHODS A case of primary lymphoma of the liver (PLL) was reported and 38 cases were reviewed from literatures since 1985RESULTS (1)2 of 15 patients with solitary lesion who had operation (10 patients)、radiotherapy (2 patients)、combination chemotherapy (3 patients) had local relapses.3 patients died.7 of 24 patients with multiple lesions treated with radiotherapy (3 patients) or/and combination chemotherapy (17 patients) had recurrence.10 patients died of disease.(2).9 of 12 patients with B symptoms died (75%) and 3 of 24 patients sithout B symptoms died (111%)P<001.CONCLUSION (1) The prognosis of patients with multiple lesions in liver and B symptoms was poor and (2) :The isolated nodule in the liver had a better local control when treated by operation、radiation or chemotherapy.(3) Chemotherapy had a higher relapse rate,radiotherapy may be beneficial for local control.