论文部分内容阅读
目的根据１１例原发于喉的恶性淋巴瘤的病例，结合文献探讨分析该病的诊断、治疗及预后。材料与方法１９７１～１９９５年共收治１１例原发于喉的恶性淋巴瘤，其主要临床表现为声嘶、咽喉痛、吞咽痛、进食异物感、吞咽困难等。间接喉镜或纤维导光镜可见声门上区或声门区肿物，肿物形态不一，可为息肉样、结节样、粘膜光滑性肿物或仅为坏死糜烂性改变。所有病例均经病理证实为非霍奇金淋巴瘤（Ｎｏｎ－Ｈｏｄｇｋｉｎ’ｓｌｙｍｐｈｏｍａ，ＮＨＬ），确诊后均行放疗，６～８ＭＶＸ线，局部野２例，扩大野９例，ＤＴ５０～７０Ｇｙ，中位ＤＴ５５Ｇｙ，放疗后均未行预防性化疗。结果全部病人疗后随访１８～１８０月，其中７例无病生存１８～１８０月，４例于疗后９～１２０月复发，均位于照射野外，２例因不能接受有效化疗死亡，２例接受正规放、化疗至今已分别无瘤生存３６月、６０月。结论原发于喉的恶性淋巴瘤少见，临床上容易误诊，确诊有赖于病理证实。放疗的局部控制作用良好，即使复发，积极治疗仍有治愈的可能。
Objective According to the 11 cases of primary malignant lymphoma in the larynx, combined with the literature to explore the diagnosis, treatment and prognosis of the disease. Materials and Methods From 1971 to 1995, a total of 11 cases of primary malignant lymphoma of the larynx were treated. The main clinical manifestations were hoarseness, sore throat, swallowing pain, eating foreign body sensation, dysphagia and so on. Indirect laryngoscopy or fiberoptic light guide can be seen in the supraglottic area or the glottis area tumor, tumor of different shapes, polyps can be like, nodular, mucosal smooth tumor or only erosive changes in necrosis. All patients were pathologically confirmed as non-Hodgkin’s lymphoma (NHL). All patients underwent radiotherapy after radiotherapy, 6-8 MV-X-ray, 2 cases of local field, 9 cases of enlarged field, DT50-70 Gy, Median DT55Gy, no preventive chemotherapy after radiotherapy. Results All patients were followed up from 18 to 180 months, of which 7 patients survived from 18 to 180 months without disease and 4 patients relapsed from 9 to 120 months after treatment, both of which were located in the field of irradiation. Two patients died of being unable to receive effective chemotherapy and two received Regular release, chemotherapy has been free of tumor-free survival of 36 months, 60 months. Conclusion Primary malignant lymphoma in the larynx is rare and is easily misdiagnosed clinically. Confirmation depends on pathological evidence. Local control of radiotherapy works well, even if the recurrence of aggressive treatment is still possible.