石河子及周边地区颈部淋巴结首发淋巴瘤的临床病理分析

ClinicoPathological Analysis of First-episode Lymphoma of Cervical Lymph Nodes in Shihezi and Surrounding Areas

目的:探讨首发于颈部淋巴结淋巴瘤的临床病理特征,为颈部淋巴结肿大相关的淋巴瘤诊疗提供思路。方法:回顾性收集58例淋巴瘤患者的临床资料,对其性别、年龄、病理类型、病程、淋巴结大小等指标进行分析。结果:58例淋巴瘤患者中,男性31例,女性27例,年龄8~81岁,中老年患者占81.03%(47/58);男女患者不同年龄组发病人数之间无差异(P>0.05);81.03%(47/58)的患者病程在6个月之内;79.31%(46/58)的患者淋巴结最大直径在2~6cm之间;15.52%(9/58)早期误诊为其他疾病;霍奇金淋巴瘤(Hodgkin's Lymphoma,HL)占12.07%(7/58),非霍奇金淋巴瘤(Non-hodgkin's Lymphoma,NHL)占87.93%(51/58);HL中结节硬化型经典型(42.86%,3/7)及混合细胞型经典型(42.86%,3/7)多见;NHL中构成比居前4位的分别是弥漫大B细胞淋巴瘤(43.14%,22/51)、滤泡性淋巴瘤(11.76%,6/51)、无特定类型B细胞淋巴瘤(9.80%,5/51)及套细胞淋巴瘤(7.84%,4/51);HL、NHL患者不同年龄组发病人数之间的差异具有统计学意义(P<0.05)。结论:颈部淋巴结首发的淋巴瘤以NHL多见;淋巴瘤主要发生在中老年患者,HL与NHL高发人群不同;常规检查无法明确诊断时,及早选择创伤相对较小的淋巴结活检以避免误诊、误治。

Objective:To investigate the clinical and pathological features of primary lymphoma in cervical lymph node,so as to provide ideas for the diagnosis and treatment of lymphoma associated with cervical lymph node enlargement.Methods:The clinical data of 58 patients with lymphoma were retrospectively collected,and the gender,age,pathological type,course of disease,lymph node size were analyzed.Results:Among the 58 patients with lymphoma,31 were male and 27 were female,aged 8-81 years,and 81.03%(47/58)were middle-aged and elderly patients.There was no difference in the number of male and female patients in different age groups(P>0.05).81.03%(47/58)of the patients had disease duration within 6 months.79.31%(46/58)of the lymph nodes had a maximum diameter between 2 and 6cm.15.52%(9/58)were early misdiagnosed as other diseases.Hodgkin's lymphoma(HL)accounted for 12.07%(7/58)and non-hodgkin's lymphoma(NHL)accounted for 87.93%(51/58).Nodular sclerosis type(42.86%,3/7)and mixed cell type(42.86%,3/7)were common in HL.The top four groups of NHL were diffuse large B-cell lymphoma(43.14%,22/51),follicular lymphoma(11.76%,6/51),B-cell lymphoma without specific type(9.80%,5/51)and mantle cell lymphoma(7.84%,4/51).There were significant differences in the number of patients with HL and NHL in different age groups(P<0.05).Conclusion:NHL is the most common lymphoma arose from cervical lymph node.Lymphoma mainly occurs in middle-aged and elderly patients,and the high incidence of HL is different from that of NHL.When the diagnosis cannot be confirmed by routine examination,lymph node biopsy with relatively small trauma should be selected as early as possible to avoid misdiagnosis and treatment.