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目的提高对原发性气管支气管淋巴瘤的认识。方法回顾性分析本院2013年和2015年收治的2例原发性气管支气管淋巴瘤患者的临床资料并进行相关文献复习。以“气管淋巴瘤”或“支气管淋巴瘤”为检索词检索中国期刊网全文数据库、万方数据库及维普数据库,以“Trachea”OR“Bronchus”AND“Lymphoma”为检索词检索Pub Med、Ovid Medline及Embase数据库,共检索到72例原发于初级支气管,并没有胸腔外淋巴瘤依据的原发性气管支气管淋巴瘤。对患者的临床、影像学、病理组织学特点、治疗及预后进行总结。结果本院收治的2例原发性气管支气管淋巴瘤患者均为女性,以“咳嗽、呼吸困难”为主诉就诊,经纤维支气管镜活检诊断为B细胞淋巴瘤1例,套细胞淋巴瘤1例。经化疗后,患者症状明显缓解,随访至2016年10月病情未复发。文献复习发现原发气管支气管淋巴瘤病发病年龄为16~82岁,中位年龄51岁,也可见于年轻人,发病年龄16~30岁9例(12.50%);女性居多(47例,占65.28%)。主要症状为呼吸困难和咳嗽,肺功能提示阻塞性通气功能障碍,胸部CT可见气管或支气管内结节影伴或不伴肺不张,支气管镜下可见肿物,病理类型以黏膜相关淋巴组织(MALT)淋巴瘤最常见(36.11%)。套细胞淋巴瘤目前尚未见报道。结论原发性气管支气管淋巴瘤是较少见的气管肿瘤之一,其临床表现、影像学和支气管镜下表现并无特异性,易与肺癌混淆,可出现危及生命的呼吸道梗阻。支气管镜检查对该病诊断有较大价值,确诊需依赖组织病理学检查。最常见病理类型为MALT淋巴瘤,其预后较好。
Objective To improve the understanding of primary tracheobronchial lymphoma. Methods The clinical data of 2 patients with primary tracheobronchial lymphoma admitted in our hospital in 2013 and 2015 were analyzed retrospectively and relevant literatures were reviewed. We searched the Chinese Journal Net Full-text Database, Wanfang Database and VIP Database with “Trachea ” OR “Bronchus ” AND “Lymphoma A total of 72 primary bronchial and primary extrabronchial lymphoma-based primary tracheobronchial lymphomas were retrieved from the Pub Med, Ovid Medline and Embase databases for the search terms. The patient’s clinical, imaging, histopathological features, treatment and prognosis were summarized. Results Two cases of primary tracheobronchial lymphoma admitted to our hospital were female. The patients were mainly complained of ”coughing and dyspnea." One case of B-cell lymphoma was diagnosed by fiberoptic bronchoscopy biopsy. Mantle cell lymphoma 1 case. After chemotherapy, the patient’s symptoms were significantly relieved. The patients were followed up until October 2016 and their disease did not recur. Literature review found that the onset of primary bronchial and bronchial lymphoma disease age is 16 to 82 years old, the median age of 51 years, also seen in young people, the age of onset of 16 to 30 years old in 9 cases (12.50%); mostly women (47 cases 65.28%). The main symptoms of dyspnea and cough, lung function prompted obstructive ventilatory dysfunction, chest CT visible tracheal or endobronchial nodules with or without atelectasis, bronchoscopic mass can be seen under the pathological type of mucosa-associated lymphoid tissue ( MALT) lymphoma is the most common (36.11%). Mantle cell lymphoma has not been reported. Conclusions Primary tracheobronchial lymphoma is one of the less common tracheal carcinomas. Its clinical manifestation, imaging and bronchoscopic features are not specific. It is easily confused with lung cancer and can lead to life-threatening airway obstruction. Bronchoscopy has great value in the diagnosis of the disease, diagnosis depends on histopathological examination. The most common type of pathology is MALT lymphoma, which has a better prognosis.