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目的:探讨原发性肾上腺淋巴瘤(PAL)的临床特点、诊治方法及预后。方法:回顾性分析8例PAL患者的临床症状、影像学表现及病理学等资料,结合相关文献分析其诊治方法及预后效果。结果:全部患者均通过影像学检查发现肾上腺肿物。其中6例行手术治疗后接受化疗,术后病理检查结果显示4例为弥漫大B细胞淋巴瘤,1例为NK细胞淋巴瘤,1例为外周T细胞淋巴瘤。1例随访6个月健在,5例分别于术后2、6、9、17、20个月死亡,另2例仅接受化疗的患者分别于出院后6、8个月死亡。结论:PAL是一种罕见的恶性肿瘤,缺乏典型的临床表现,FDG-PET在诊断上具有优势;该肿瘤预后差,合并肾上腺皮质功能低下的患者更差;手术联合化疗效果优于单一治疗。
Objective: To investigate the clinical features, diagnosis and treatment of primary adrenal lymphoma (PAL) and its prognosis. Methods: The clinical symptoms, imaging findings and pathology of 8 patients with PAL were retrospectively analyzed. The diagnosis and treatment methods and prognosis were analyzed based on the relevant literature. Results: All patients had adrenal gland findings by imaging examination. Of these, 6 received chemotherapy after surgery, and postoperative pathology revealed 4 cases of diffuse large B-cell lymphoma, 1 case of NK cell lymphoma and 1 case of peripheral T-cell lymphoma. One patient was followed up for 6 months and 5 patients died after 2, 6, 9, 17 and 20 months respectively. The other 2 patients who received chemotherapy only died 6 and 8 months after discharge respectively. Conclusion: PAL is a rare malignant tumor with no typical clinical manifestations. FDG-PET has an advantage in diagnosis. The poor prognosis of the tumor is even worse in patients with adrenal insufficiency. The combination of surgery and chemotherapy is superior to single treatment.