原发性肺非霍奇金淋巴瘤的临床特点及预后分析

Clinical characteristics and prognosis of primary pulmonary non-Hodgkin's lymphoma

目的研究原发性肺非霍奇金淋巴瘤(PPL)的临床特征及预后。方法回顾性分析北京协和医院确诊的30例PPL的临床表现、诊断手段、病理类型以及预后。结果病例中,男性占46.7%,中位年龄为46岁。PPL患者没有特异的临床症状及影像学表现,甚至20%患者可无任何症状。中位发病至诊断时间为8个月,经支气管肺活检及经CT引导下肺活检的诊断率分别为33.3%和50%,而胸腔镜下肺活检及开胸肺活检的诊断率为100%。黏膜相关淋巴组织(MALT)淋巴瘤最为常见,占56.7%。在中位随诊39个月后,30例患者中有7例患者(23.3%)死亡。MALT组患者较非MALT组患者有着更低的IPI评分及更好的预后。结论 PPL是一种罕见的结外淋巴瘤,其诊断较为困难,非MALT类型的淋巴瘤患者预后较差。

Objective To study the clinical characteristics and outcome of patients with primary pulmonary non-Hodgkin＇s lymphoma（PPL）.Methods The clinical features,diagnostic methods,pathological types and outcome of 30 patients with PPL diagnosed in PUMC Hospital were analyzed retrospectively.Results Of these 30 patients,46.7% of patients were male and the median age was 46 years.These patients didn＇t have specific clinical symptoms and radiological features and 20% patients were asymptomatic.The median time from onset to diagnosis of all patients was 8 months.The positive diagnostic rate of transbronchial lung biopsy,lung biopsy guided by computer tomography,and lung biopsy by thoracoscopy was 33.3%,50% and 100%,respectively.The mucosa-associated lymphoid tissue（MALT） lymphoma was the main type in PLL,which was found in 56.7% patients.Seven of 30 patients died after 39 months of median follow-up time.Compared with patients with non-MALT lymphoma,patients with MALT lymphoma had lower international prognostic index（IPI） score and better prognosis.ConclusionThe PPL is an uncommon extra-nodular lymphoma and is difficult to diagnose.The patients with non-MALT lymphoma have better prognosis in PPL.