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目的:探讨原发性肾淋巴瘤(primary renal lymphoma,PRL)的临床病理、诊断及预后特征。方法:回顾性分析2011年1月至2016年7月就诊于郑州大学第一附属医院22例PRL患者的临床特征、病理学特征、免疫表型、诊断、治疗及预后。结果:22例PRL患者的年龄2~72岁,平均年龄54.3岁,≥50岁为13例(59.1%)。病理学检查以非霍奇金淋巴瘤常见,其中B细胞淋巴瘤20例,T细胞淋巴瘤2例。PRL:7例生存,生存时间6~50个月;15例死亡,生存时间5~35个月。结论:PRL临床比较罕见,临床表现及影像学表现特异性小,容易漏诊或误诊,组织病理学仍是确诊该病的金标准。组织学类型以B细胞性为主,弥漫性大B细胞性淋巴瘤(diffuse large B-cell lymphoma,DLBCL)最常见。根据随访结果得出生存时间与发病年龄、性别、组织学类型等有关。PRL暂无成熟的治疗经验,治疗方案亟待临床病例数的扩大,以及临床诊治经验的进一步积累。目前临床针对该病主要以行手术为主,辅助以化疗的综合治疗方式;对于局部晚期或高恶性度的肿瘤,单纯化疗通常疗效满意。
Objective: To investigate the clinicopathologic features, diagnosis and prognosis of primary renal lymphoma (PRL). Methods: The clinical features, pathological features, immunophenotypes, diagnosis, treatment and prognosis of 22 patients with PRL admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to July 2016 were retrospectively analyzed. Results: The age of patients with PRL in 22 cases was 2 to 72 years old, with an average age of 54.3 years and 13 cases (≥ 50 years) (59.1%). Pathological examination with non-Hodgkin’s lymphoma common, including 20 cases of B-cell lymphoma, T-cell lymphoma in 2 cases. PRL: 7 cases of survival, survival time 6 to 50 months; 15 patients died, the survival time of 5 to 35 months. CONCLUSIONS: PRL is rare in clinical practice. It has small clinical manifestations and imaging manifestations, and is easily missed or misdiagnosed. Histopathology is still the gold standard for the diagnosis of the disease. Histological type of B-cell-based, diffuse large B-cell lymphoma (diffuse large B-cell lymphoma, DLBCL) the most common. According to follow-up results obtained survival time and age of onset, gender, histological type and so on. No mature PRL treatment experience, the number of clinical treatment programs to be expanded and the clinical diagnosis and treatment of further accumulation. At present, clinical mainly focuses on the operation of the disease mainly on the basis of chemotherapy, and assists the comprehensive treatment of chemotherapy. For locally advanced or malignant tumors, chemotherapy alone usually has satisfactory curative effect.