CAJ | 학술논문

目的分析胸膜原发性弥漫大B细胞淋巴瘤(DLBCL)的临床特征、辅助检查及诊治经过,提高临床医生对该病的认识.方法报道1例2013年12月确诊的DLBCL患者的临床表现、辅助检查及诊治经过,并结合文献进行回顾性分析.以“胸膜原发性,淋巴瘤”为检索词通过万方数据库和中国知网对中文文献进行检索;以“primary pleural,lymphoma”为检索词通过PubMed数据库进行检索,检索时间截至2014年3月.结果患者男,73岁,因“左侧胸痛1个月”收入山东省立医院.患者主要症状为左侧胸痛,偶有咳嗽.胸部CT示左侧胸腔积液,左胸膜增厚.胸腔镜检查术发现患侧脏、壁胸膜多发大小不等的结节,活检病理诊断为DLBCL.确诊后行CHOP方案化疗3次,随访至今未复发.在万方数据库、中国知网、PubMed数据库共检索到胸膜原发性DLBCL的相关文献12篇,全部为个案报道.男8例,女4例,年龄12 ～81岁.临床症状以胸痛和发热为主.结论胸膜原发性DLBCL较为罕见,临床表现及影像学特征缺乏特异性,极易漏诊和误诊,最终需依靠病理活检明确诊断,及时行胸腔镜检查是确诊DLBCL的最有效方法.
목적 분석흉막원발성미만대B세포림파류(DLBCL)적림상특정、보조검사급진치경과,제고림상의생대해병적인식.방법 보도1례2013년12월학진적DLBCL환자적림상표현、보조검사급진치경과,병결합문헌진행회고성분석.이“흉막원발성,림파류”위검색사통과만방수거고화중국지망대중문문헌진행검색;이“primary pleural,lymphoma”위검색사통과PubMed수거고진행검색,검색시간절지2014년3월.결과 환자남,73세,인“좌측흉통1개월”수입산동성립의원.환자주요증상위좌측흉통,우유해수.흉부CT시좌측흉강적액,좌흉막증후.흉강경검사술발현환측장、벽흉막다발대소불등적결절,활검병리진단위DLBCL.학진후행CHOP방안화료3차,수방지금미복발.재만방수거고、중국지망、PubMed수거고공검색도흉막원발성DLBCL적상관문헌12편,전부위개안보도.남8례,녀4례,년령12 ～81세.림상증상이흉통화발열위주.결론 흉막원발성DLBCL교위한견,림상표현급영상학특정결핍특이성,겁역루진화오진,최종수의고병리활검명학진단,급시행흉강경검사시학진DLBCL적최유효방법.
Objective To analyze the clinical features of 1 case of primary pleural diffuse large B-cell lymphoma (DLBCL) and therefore to improve the understanding of this disease.Methods The clinical features,auxiliary examinations and diagnosis of a case with DLBCL were reported and the related literatures were reviewed.The literature review was carried out respectively with " primary pleural,lymphoma",as the search terms in Wanfang Data,CNKI and PubMed by December 2013.Results A 73 year-old male patient was admitted to the hospital because of chest pain on the left side for 1 month.The main symptoms of the patient were left side chest pain,with occasional cough.Chest CT scan showed left pleural effusion and pleural thickening.Thoracoscopy was performed and revealed multiple sizes of nodules on the visceral and parietal pleura.Pathology study confirmed the diagnosis of DLBCL The patient was treated with CHOP regimen 3 times.So far,there was no local recurrence.A total of 12 literatures were retrieved from Wanfang Data,CNKI and PubMed,and they were all case reports.There were 8 male and 4 female patients,aging from 12 to 81 years.The main symptoms were chest pain and fever.Conclusions Primary pleural DLBCL is a rare disease.It is easily to be misdiagnosed due to non-specific clinical and imaging manifestations.The final diagnosis depends ultimately on pathological biopsy,and thoracoscopy is the most effective method to confirm DLBCL.