妊娠期淋巴瘤的诊断及处理进展

Diagnosis and management of lymphoma during pregnancy

淋巴瘤是一种淋巴系统来源的恶性肿瘤,包括霍奇金淋巴瘤和非霍奇金淋巴瘤。妊娠期淋巴瘤的发生率占妊娠期新发恶性肿瘤的第4位,是影响母儿结局的主要恶性疾患之一。本文回顾文献,总结了妊娠期淋巴瘤的临床特点、诊断、母儿结局及临床处理。临床医生应重视妊娠期妇女出现不明原因淋巴结肿大、全身症状、结外病灶及病灶对局部脏器所产生的压迫症状,特别是乳腺及生殖系统出现的病灶,并应及时通过病灶活检或穿刺进行诊断。临床处理时,需根据患者的淋巴瘤分型、分期及临床表现,结合诊断时孕周、母儿情况,以及继续妊娠的意愿,协同多学科医生进行个体化诊疗,并重视围分娩期处理。多数母儿可获得较好结局。

Lymphoma is a malignant tumor of the lymphatic system,including Hodgkin's lymphoma and non-Hodgkin's lymphoma.Lymphoma is the fourth most common primary malignant tumor during pregnancy and one of the major malignant diseases affecting maternal and infant outcomes.This review summarizes the clinical features,diagnosis,maternal and fetal outcomes,and clinical lymphoma treatment during pregnancy.It is suggested that clinicians should pay attention to the symptoms,including unexplained lymphadenectasis,systemic symptoms,extranodal lesions,and the symptoms of pressure exerted on the involved local organs,especially those in the breast and reproductive system,and make a timely diagnosis in line with the biopsy or puncture results.Management should be based on the classification,stage,and clinical manifestations of lymphoma.Besides,the gestational age at diagnosis,maternal and child conditions,and the willingness to continue the pregnancy should also be considered.Most mothers and their children can have good outcomes after individualized treatment through multidisciplinary cooperation and close perinatal management.