骨原发非霍奇金淋巴瘤15例临床分析

Primary Non-Hodgkin's Lymphoma of Bone:Clinical Analyses of 15 Patients

目的探讨骨原发非霍奇金淋巴瘤的临床特点与治疗。方法回顾性分析15例骨原发非霍奇金淋巴瘤患者的症状、体征、影像学特征、病理组织学表现和治疗。结果15例患者的年龄为19～69岁,中位年龄54岁。主要临床表现为病变部位疼痛。单发病灶13例,多发病灶2例。骨病变部位X线及CT表现以溶骨性病变为主,MRI及骨扫描可对诊断提供帮助。病理组织学类型多为弥漫大B细胞型淋巴瘤。治疗主要采取手术、局部放疗和全身化疗。结论该病是一种少见的结外淋巴瘤,单骨侵犯多见,影像学表现对诊断有所提示但不能定性,骨病变部位的病理组织学及免疫组织化学检测是确诊依据。治疗以全身化疗结合局部放疗效果较好。

Objective To investigate the clinical performances Primary non - Hodgkin＇s Lymphoma of Bone （PLB） and its therapy. Methods The clinical symptoms, signs, imaging features, histopathological presentations and treatments were analyzed retrospectively in 15 PLB patients. Results The patients＇ median age was 54 years, ranging from 19 to 69 years. The main complains were local pain and tenderness. Single lesion was noted in 13 cases, multiple in 2. X -ray and CT manifesta- tions were mainly osteolytic lesions. MRI and bone scan helped. Histopathological types were most diffuse large B - cell lympho- ma. Treatments for PLB included local excision and radiotherapy, and systemic chemotherapy. Conclusion PLB, a rare dis- ease, generally involved a single bone. The final diagnosis of PLB depends on histopathological presentations and immunohisto- chemical assays. Image features are helpful. Local radiotherapy combined with chemotherapy is of better effect.