原发性泌尿生殖系统淋巴瘤的临床特点分析

Analysis on clinical characteristics of primary genitourinary lymphoma

目的探讨原发性泌尿生殖系统淋巴瘤的临床特点、诊断治疗方法及预后。方法收集福建省立医院泌尿外科自2012年1月~2019年6月期间收治的12例原发性泌尿生殖系统淋巴瘤患者的临床资料。结果本组病例发病年龄48~84岁,平均(64.4±3.8)岁。临床表现:3例原发性肾上腺淋巴瘤,1例原发性肾脏淋巴瘤,4例原发性膀胱淋巴瘤,以排尿困难、血尿,下腹痛伴尿道刺激症状就诊。本研究纳入病例中10例患者病理报告为:弥漫性大B细胞淋巴瘤(Diffuse large B cell lymphoma,DLBCL),均为非生发中心型(N-GCB)。另外2例病理结果:1例为膀胱黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤),1例采用R-CHOP(利妥昔单抗+环磷酰胺+表阿霉素+长春新碱+泼尼松)方案化疗3个疗程。结论原发性泌尿生殖系统淋巴瘤临床表现缺乏特异性,预后较差,误诊率高,影像学检查有助于进一步鉴别诊断,病灶穿刺活检能提供有效病理支持,治疗主张采取手术治疗与全身化疗相结合的方案。

Objective To explore the clinical features,diagnosis and treatment methods,and prognosis of primary genitourinary lymphoma.Methods The clinical data of 12 patients with primary genitourinary lymphoma who were admitted to the Department of Urinary Surgery of Fujian Provincial Hospital from January 2012 to June 2019 were collected.Results The age of onset of cases in this group was 48-84 years,and the average age of onset was(64.4±3.8)years.Clinical manifestations were 3 cases of primary adrenal lymphoma,1 case of primary renal lymphoma,and 4 cases of primary bladder lymphoma.The patients were admitted due to dysuria,hematuria,lower abdominal pain and urinary tract irritation;the pathological reports of 10 patients included in this study were diffuse large B cell lymphoma(DLBCL),all of which were non-germinal centre B cells(N-GCB).Pathological results of the other 2 cases were 1 case with bladder mucosa-associated lymphoid tissue lymphoma(MALT lymphoma),and 1 case receiving R-CHOP(rituximab+cyclophosphamide+epirubicin+vincristine+prednisone)regimen for 3 courses of chemotherapy.Conclusion The clinical manifestations of primary genitourinary lymphoma lack specificity,the prognosis is poor,and the misdiagnosis rate is high.Imaging examination can help further differential diagnosis,and the lesion needle biopsy can provide effective pathological support.The treatment advocates a combination of surgical treatment and systemic chemotherapy.