原发性头颈部非霍奇金淋巴瘤62例临床分析

Clinical analysis of primary head and neck non-hodgkin's lymphoms

目的 :探讨原发性头颈部非霍奇金淋巴瘤 (NHL)的临床特征。方法 :分析 6 2例头颈部NHL的临床资料。结果 :腭扁桃体 (2 5 .8% )、颈淋巴结 (19.4 % )、鼻腔及鼻窦 (12 .9% )为NHL的好发部位 ;临床分期ⅠE期和ⅡE期分别为 38.7%、2 4 .2 %。病理分型高度恶性为 75 .8%。CR率 75 .8% ,PR率 14 .5 % ,有效率 90 .3% ;部分患者无瘤长期生存。结论 :头颈部NHL一般恶性度高 ,多发于结外组织且易发生淋巴结转移 ,准确的取材活检结合免疫组化有利于早期确诊 ,治疗上应采用化疗、放疗或结合手术的综合治疗方案。

Objective:To research the clinical features of primary head and neck non Hodgkin's lymphoms(NHL). Method: 62 patients with primary head and neck NHL were analyzed in the positions of focuses, clinical aspects, diagnosis and treatment. Result: Tonsilla palatina( 25.8 %), cervical lymphonodi ( 19.4 %), nasal cavity and nasal sinuses( 12.9 %) were the common place of the origin of NHL which had various clinical manifestations. High grade malignant lymphomas represented 75.8 % of these cases whose ⅠE stage and ⅡE stage were 38.7 % and 24.2 % respectively. The complete response, partial response, and response rate were 75.8 %, 14.5 %,and 90.3 %, respectively. Some patients had been long term survival without tumor. Conclusion: Head and neck NHL is generally high degree malignancy. It often originates from outside lymph node and easily metastasizes to lymph node. Accurate surgical biopsy linking immunohistochemical test will be advantageous to make a definite diagnosis. Combining Chemotherapy and radiotherapy or operation should be put into practice to improve prognosis.