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目的总结以腹部包块起病的恶性淋巴瘤患者的临床表现、病理及治疗反应等临床特点。方法对1998~2003年解放军总医院收治的35例以腹部包块起病的恶性淋巴瘤患者的病例及随访资料进行回顾性分析。随访时间16~96个月。结果男性患者占74·3%;以腹膜后淋巴结肿大最多(71·4%);非霍奇金淋巴瘤(NHL)占91·4%(32/35),霍奇金病占8·6%(3/35);非霍奇金淋巴瘤患者中40~50岁发病占15/32(46·9%);NHL中B细胞来源非霍奇金淋巴瘤(B-NHL)比例65·6%(21/32),T细胞来源非霍奇金淋巴瘤(T-NHL)占28·1%(9/32),2例未分型占6·3%;3例霍奇金病患者中1例死于复发,非霍奇金淋巴瘤患者死亡9例,其中常规化疗组6例,移植组3例;起病时伴有肝功能异常及腹水的患者4例中2例死亡。结论以腹部包块起病的恶性淋巴瘤男性多见;B-NHL多见;临床表现以腹部症状为主,包块巨大、有腹水及肝功异常者预后差。
Objective To summarize the clinical features, pathology and therapeutic response of patients with malignant lymphoma with abdominal mass. Methods A retrospective analysis was performed on the 35 cases of malignant lymphoma patients with abdominal mass from 1998 to 2003 in the PLA General Hospital. Follow-up time of 16 to 96 months. Results Male patients accounted for 74.3%, with the largest number of retroperitoneal lymph nodes (71.4%), non-Hodgkin’s lymphoma (NHL) 91.4% (32/35), Hodgkin’s disease 8 6% (3/35). The incidence of non-Hodgkin’s lymphoma was 40/50 (46.9%) in 40-50 years old. The proportion of B-NHL in NHL was 65 · 6% (21/32), T-cell non-Hodgkin’s lymphoma (T-NHL) accounted for 28.1% (9/32) One patient died of recurrent disease, 9 patients died of non-Hodgkin’s lymphoma, of which 6 patients in conventional chemotherapy group and 3 patients in transplantation group; 2 patients died of liver dysfunction and ascites in onset . Conclusion Malignant lymphoma with abdominal mass is common in men. B-NHL is more common. The main clinical manifestations are abdominal symptoms. The masses are massive with poor prognosis of ascites and abnormal liver function.