伴纵隔大包块淋巴瘤17例临床分析

Lymphoma with mediastinal bulky masses： a clinical analysis of 17 cases

目的 分析伴纵隔大包块淋巴瘤的临床特点、病理诊断和治疗方法.方法 回顾性分析2010年1月至2017年1月北京友谊医院诊治的17例伴纵隔大包块淋巴瘤患者临床资料.结果 17例患者均经病理诊断确诊,其中原发纵隔大B细胞淋巴瘤6例,T淋巴母细胞淋巴瘤5例,霍奇金淋巴瘤3例,其他类型非霍奇金淋巴瘤3例.4例采用化疗联合放疗,7例采用单纯化疗,5例采用化疗联合自体造血干细胞移植,1例化疗后进行异基因造血干细胞移植.终止治疗后评估疗效：完全缓解12例,部分缓解1例,疾病稳定1例,死亡3例.结论 伴纵隔大包块淋巴瘤患者的预后与病理类型及治疗反应有关,采用积极的化疗联合放疗及化疗联合自体或异基因造血干细胞移植可能有助于提高疗效.

Objective To analyze the clinical characteristics, pathological types, treatment modalities of lymphoma patients with mediastinal bulky masses. Methods The clinical data of 17 lymphoma patients with mediastinal bulky masses from January 2010 to January 2017 in Beijing Friendship Hospital were analyzed retrospectively. Results All the patients were pathologically diagnosed, including 6 cases of primary mediastinal large B-cell lymphoma, 5 cases of lymphoblastic lymphoma, 3 cases of Hodgkin lymphoma and 3 cases of other non-Hodgkin lymphoma. Four cases with bulky disease were treated with combined chemoradiotherapy regimen, 7 cases were treated with combined chemotherapy, 5 cases were treated with combined chemotherapy regimens followed by autologous bone marrow transplantation and 1 case was treated with high dose chemotherapy followed by allogeneic stem cell transplantation. The effects were evaluated after the final treatments. Twelve patients achieved complete remission, 1 case achieved partial remission, 1 case achieved stable disease, 1 case achieved progressive disease and 3 cases died. Conclusions The prognosis of lymphoma patients with mediastinal bulky masses is related with histopathology and treatment response. Combined treatment modalities including chemoradiotherapy regimen and chemotherapy regimen followed by autologous or allogeneic stem cell transplantation are helpful to improve treatment effects.