原发性肾上腺非霍奇金淋巴瘤2例报告并文献复习

Primary non-Hodgkin′s lymphoma of the adrenal gland: A two care report and literature review

目的探讨原发性肾上腺非霍奇金淋巴瘤的诊断与治疗。方法 2001年6月至2011年1月收治原发性肾上腺非霍奇金淋巴瘤2例,均为男性,平均年龄80岁。临床上均为查体发现,无特异性表现。肿瘤均位于左侧,直径平均5.7(5.5～6)cm。2例均行手术治疗,1例行腹腔镜左肾上腺肿瘤切除术,1例行开放性左肾上腺肿瘤切除术。结果病理诊断均为左肾上腺弥漫性大B细胞型淋巴瘤。术后均行美罗华(R-CHOP+环磷酰胺+阿霉素+长春新碱+泼尼松)方案治疗,1例已随访20个月,另1例随访6个月。结论原发性肾上腺非霍奇金淋巴瘤是一种罕见的恶性肿瘤,该病好发于老年男性,临床表现无特异性,明确诊断需依靠病理检查,该病恶性程度高,对治疗不敏感,预后差。

Objective To explore the diagnosis and treatment of primary adrenal lymphoma （PAL）. Methods Two cases of PAL（males, at a mean age of 80 years） from June 2001 to January 2011 in our hospital were retrospectively analyzed. The disease, without special clinical manifestation, was found by physical examination. Tumors were located on the left adrenal gland, and averaged 5.7 （5.5 - 6） cm in diameter. The two patients were treated with operation, one with laparoscopic surgery, and the other with routine open surgery. Results The tumors were pathologically diagnosed as diffuse large B cell lymphoma of the left adrenal gland. After operation, the patients were treated with R- CHOP （rituximab ＋ cyclophosphamide ＋ doxorubicin ＋ vincristine ＋ prednisone） regime, and followed up for 6 and 20 months, respectively. Conclusions PAL is an extremely rare malignant tumor, and usually occurs in old men without special clinical manifestation. It can be definitely diagnosed dependent on pathological examination. PAL, which is not sensitive to treatment, has a poor prognosis.