原发性肾上腺淋巴瘤的临床特点分析

Analysis of Clinical Characteristics for Primary Adrenal Lymphoma

目的:探讨原发性肾上腺淋巴瘤(Primary Adrenal Lymphoma,PAL)的临床特点,增强对PAL诊治和预后的认识。方法:回顾性分析2例PAL患者的临床资料,并结合相关文献进行临床特点的分析。结果:2例患者影像学检查均发现肾上腺肿物。经病理组织学诊断1例为弥漫大B细胞淋巴瘤,另1例为结外NK/T细胞淋巴瘤。前者拒绝治疗,明确诊断后第32天死亡;后者因化疗前并发急性胰腺炎,接受了"Gem Ox"方案化疗,联合"VP-16+DXM"方案控制噬血细胞综合征,病情短暂好转后迅速恶化,因出现多器官功能衰竭于化疗后第40天死亡。结论:PAL是一种罕见的、恶性程度较高的结外淋巴瘤,治疗以放化疗联合治疗模式为主。PAL不同病理类型患者预后差异较大,根据病理类型选择合适的治疗方案对延长患者生存期极为重要。

Objective： To explore clinical characteristics of the Primary Adrenal Lymphoma（PAL）, so as to enhance the understanding of diagnosis, treatment and prognosis of PAL. Methods： The clinical data of 2 patients with PAL retrospectively analyzed and the clinical characteristics were explored in combination with releted literalures. Results：Adrenal gland neoplasm was found in 2 patients by imaging examination. The pathological type of one case was diffuse large B cell lymphoma, the other one was extranodal NK/T-cell lymphoma. The former refused to hosipitali3 t and the other received to be admited in hospital after the definite diagnosis. She died at the 32 th day after diagnosis, due to the complication with acute pancreatitis before chemotherapy. The latter accepted the scheme of ＂Gemox＂ combining with the scheme ＂VP-16＋DXM＂ to control hemophagocytic lymphohistiocytosis. The patient＇s condition deteriorated rapidly after a short period of improvement, then died at the 40 th day after chemotherapy because of multiple organ failure.Conclusion： PAL is a rare extra-nodal lymphoma with higher malignancy, the combination of chemotherapy and radiotherapy results in the best outcome among all the treatments. The prognosis of patients with different pathological types was diverse, thus it is very important to choose the appropriate treatment according to different pathological types.