原发性骨淋巴瘤3例并文献复习

Primary non - Hodgkin's lymphoma of bone(PLB) : three Case report and literature review

目的:探讨原发性骨淋巴瘤的临床特征、治疗方法及预后。方法:对南京八一医院确诊为原发性骨淋巴瘤的3例患者的临床资料进行回顾性分析。结果:随访8月-11年,采用化疗联合放疗2例,均存活。单纯化疗1例,因病情进展已死亡。结论:原发性骨淋巴瘤为临床少见的结外淋巴瘤,以弥漫大B细胞性非霍奇金淋巴瘤多见,预后较好。通常见为溶骨性破坏,局部症状重而全身症状轻,影像学检查无特异性,造成早期准确诊断非常困难,容易发生误诊。确诊有赖于病理及免疫组化证实。治疗以放化疗综合治疗为宜。

Objective：To analyze the clinical characteristics,treatment and prognosis of PLB.Methods：Three cases of histological confirmed primary lymphoma of bone in Nanjing 81 Hospital of PLA were retrospectively analyzed.Results：The follow-up range 1 to 11 years.Two patients were treated with chemotherapy and irradiation still alive,and one patient treated with chemotherapy only died of disease progression.Conclusion：PLB are uncommon malignancies.Patients with PLB commonly present with local bone pain,soft tissue swelling,and a mass or a pathological fracture.Most cases of PLB are classified as diffuse large B-cell lymphomas（DLBCL） in the WHO classification of hematological malignancies,which prognosis is better.Comprehensive immunohistochemical studies are required to establish an histological of PLB.Early diagnosis and the differentiation from other disease and active treatment should be performed.Combination therapy including radiotherapy and chemotherapy is the optimal treatment for PLB.