中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
12期
950-953
,共4页
乳腺肿瘤%淋巴瘤%诊断%预后
乳腺腫瘤%淋巴瘤%診斷%預後
유선종류%림파류%진단%예후
Breast neoplasms%Lymphoma%Diagnosis%Prognosis
目的 探讨乳腺原发性淋巴瘤(primary breast lymphoma,PBL)诊治方法.方法 回顾性分析1997年1月-2011年12月天津市肿瘤医院收治并有完整资料的49例PBL患者临床病理资料.结果 全组1例男性,48例女性,高发年龄在35 ～ 55岁之间;无痛性肿物多为首诊症状,右侧乳腺多发,且多位于乳腺外上象限,占61.11％.术前乳腺B超及X检查易与良性肿物混淆,粗针穿刺活检及术中快速冰冻病理诊断率亦不高;最后病理诊断1例为霍奇金淋巴瘤,48例为非霍奇金淋巴瘤,均为B细胞来源;全组46例患者接受手术和化疗治疗,其中16例同时接受放疗治疗,化疗以CHOP方案为主.中位随访时间为40个月,5年总生存率和无病生存率分别为48％和28％,骨髓为最常见转移部位.结论 PBL预后差,影像学检查缺乏特异性,术后石蜡病理和免疫组化检测是主要确诊手段,外科治疗不推荐根治性手术,应采取以化疗为主的全身综合性治疗方案.
目的 探討乳腺原髮性淋巴瘤(primary breast lymphoma,PBL)診治方法.方法 迴顧性分析1997年1月-2011年12月天津市腫瘤醫院收治併有完整資料的49例PBL患者臨床病理資料.結果 全組1例男性,48例女性,高髮年齡在35 ～ 55歲之間;無痛性腫物多為首診癥狀,右側乳腺多髮,且多位于乳腺外上象限,佔61.11％.術前乳腺B超及X檢查易與良性腫物混淆,粗針穿刺活檢及術中快速冰凍病理診斷率亦不高;最後病理診斷1例為霍奇金淋巴瘤,48例為非霍奇金淋巴瘤,均為B細胞來源;全組46例患者接受手術和化療治療,其中16例同時接受放療治療,化療以CHOP方案為主.中位隨訪時間為40箇月,5年總生存率和無病生存率分彆為48％和28％,骨髓為最常見轉移部位.結論 PBL預後差,影像學檢查缺乏特異性,術後石蠟病理和免疫組化檢測是主要確診手段,外科治療不推薦根治性手術,應採取以化療為主的全身綜閤性治療方案.
목적 탐토유선원발성림파류(primary breast lymphoma,PBL)진치방법.방법 회고성분석1997년1월-2011년12월천진시종류의원수치병유완정자료적49례PBL환자림상병리자료.결과 전조1례남성,48례녀성,고발년령재35 ～ 55세지간;무통성종물다위수진증상,우측유선다발,차다위우유선외상상한,점61.11％.술전유선B초급X검사역여량성종물혼효,조침천자활검급술중쾌속빙동병리진단솔역불고;최후병리진단1례위곽기금림파류,48례위비곽기금림파류,균위B세포래원;전조46례환자접수수술화화료치료,기중16례동시접수방료치료,화료이CHOP방안위주.중위수방시간위40개월,5년총생존솔화무병생존솔분별위48％화28％,골수위최상견전이부위.결론 PBL예후차,영상학검사결핍특이성,술후석사병리화면역조화검측시주요학진수단,외과치료불추천근치성수술,응채취이화료위주적전신종합성치료방안.
Objective To evaluate the diagnosis and treatment of primary breast lymphoma(PBL).Methods Clinical data of 49 PBL cases diagnosed in our center from 1997 to 2011 was retrospectively analyzed.Results 1 case was male,48 cases were female.Most patients were at the age of 35-55 years.Painless mass was the most common symptom which was most often seen on the upper-outer quadrant of the right breast,accounting for 61.11％ in this group.Preoperative misdiagnosis rate was high by mammography,B ultrasonic and hollow needle pathologic examination.Final diagnosis could only made by postoperative histopathologic examination.In this group 1 case was Hodgkin lymphoma and 48 cases were non-Hodgkin lymphoma(NHL) originating from B cells.46 patients underwent surgery and chemotherapy followed by radiotherapy in 16 cases.Median time of follow up was 40 months,5-year overall and disease free survival was 48％ and 28％ respectively,and bone marrow was the most common metastatic organ.Conclusions The prognosis of PBL is poor.The image diagnosis lacks specificity.Paraffin sections and immunohistochemistry were the main means to make a definite diagnosis.Chemotherapy-based comprehensive treatment is the strategy in the management of PBL instead of radical mastectomy.
