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为了探讨同时性双原发非霍奇金淋巴瘤合并上皮性癌的临床病理学特征,对5例同时性双原发非霍奇金淋巴瘤合并上皮性癌进行形态学和免疫组织化学观察,结合临床资料进行分析并复习相关文献。5例同时性双原发非霍奇金淋巴瘤合并上皮性癌患者中男2例,女3例,年龄52~64岁。5例患者均属于同发性肿瘤,其中2例是术前检查时发现,1例是术中发现,2例是术后复查中发现。本研究中5例淋巴瘤患者均为B淋巴细胞性,其中3例为结外弥漫性大B细胞淋巴瘤(DLBCL),1例为淋巴结DLBCL,1例为淋巴结惰性小B细胞淋巴瘤;5例上皮性癌中4例为腺癌,另1例为甲状腺髓样癌。4例DLBCL合并癌患者均先行积极的手术治疗,并辅以针对性的术后化疗方案(或放疗),随访5~50个月均生存。初步研究结果提示,淋巴瘤与癌同时性双原发的病例非常少见,术前、术中和术后全面仔细的检查有助于发现多原发恶性肿瘤。该类患者临床应积极行根治性手术,并辅以术后规范化化疗以延长患者生命。
To investigate the clinicopathological features of concurrent primary non-Hodgkin’s lymphoma with epithelial carcinoma, morphological and immunohistochemical studies were performed in 5 patients with concurrent primary non-Hodgkin’s lymphoma with epithelial carcinoma. Combined with clinical data analysis and review of relevant literature. Five patients with concurrent primary non-Hodgkin’s lymphoma with epithelial carcinoma included 2 males and 3 females, aged 52-64 years. All 5 patients belonged to the same tumor. Two of them were found during the preoperative examination, one was found intraoperatively and two were found after the operation. Five patients with lymphoma in our study were all B lymphocytes, of which 3 were extracranial diffuse large B-cell lymphoma (DLBCL), 1 was lymph node DLBCL and 1 was lymph node-deficient small B-cell lymphoma; 5 Four cases of epithelial carcinoma were adenocarcinoma and the other one was medullary thyroid carcinoma. All 4 patients with DLBCL complicated with cancer underwent active surgical treatment, and were supplemented with targeted postoperative chemotherapy (or radiotherapy), and were followed up for 5 to 50 months. Preliminary results suggest that lymphoma and cancer concurrent dual primary cases are very rare, preoperative, intraoperative and postoperative comprehensive and detailed examination can help find multiple primary malignant tumors. Such patients should be aggressive clinical radical surgery, combined with postoperative standard chemotherapy to extend patient life.