论文部分内容阅读
目的分析13例艾滋病相关非霍奇金淋巴瘤(ARL)病人的临床资料,探讨其治疗时机和治疗方案。方法采用回顾性分析的方法,对龙潭医院2008年10月至2013年6月收治的艾滋病(AIDS)合并ARL住院病人的临床特点、免疫水平、并发症、病理检查及治疗情况、转归等进行分析。结果 13例ARL病人中,男性11例,女性2例,年龄24~71岁。10例在淋巴瘤诊治中首次发现艾滋病病毒(HIV)感染,2例分别在抗病毒治疗(ART)1个月和4个月后发现ARL,1例在诊断HIV感染后4个月发现ARL(未行ART)。发病时CD+4T淋巴细胞计数为21~340个/μL。10例为B细胞淋巴瘤,其中1例为Burkitt淋巴瘤,1例为黏膜相关性淋巴样组织淋巴瘤(MALT),6例为弥漫大B细胞性淋巴瘤,2例未能进一步分型;2例未分型,1例为T细胞淋巴瘤。以颈部肿物、腹股沟肿物、腋下包块、盆腔肿块及锁骨上肿物等为首发症状的7例,上消化道出血、便血、腹胀及腹痛、吞咽时胸骨后灼热痛、发热伴咽痛、发热伴头痛等起病6例。8例进行了ART,4例进行了化疗。4例未随访,7例死亡。结论HIV感染者若出现不明原因的淋巴结肿大、发热、消化道出血等,应考虑并发淋巴瘤的可能,必要时行淋巴结活检以明确诊断。积极的ART联合规范性化疗,以及适当的治疗时机仍需要补充更多的临床实践资料进行讨论。
Objective To analyze the clinical data of 13 patients with AIDS-related non-Hodgkin's lymphoma (ARL) and discuss the treatment timing and treatment options. Methods The retrospective analysis was used to analyze the clinical features, immunological level, complications, pathological examination, treatment and outcomes of AIDS patients with ARL admitted from October 2008 to June 2013 in Longtan Hospital analysis. Results Of 13 ARL patients, 11 were male and 2 were female, aged from 24 to 71 years. In 10 cases, the first HIV infection was found in the diagnosis and treatment of lymphoma. Two cases were found ARL at 1 month and 4 months after anti-virus therapy (ART) respectively. ARL was found at 4 months after diagnosis of HIV infection No ART). The incidence of CD + 4T lymphocyte count was 21 to 340 / μL. Ten cases were B cell lymphomas, one case was Burkitt lymphoma, one case was mucosa associated lymphoid tissue lymphoma (MALT), six cases were diffuse large B cell lymphoma and two cases failed to further type. 2 cases did not type, 1 case of T cell lymphoma. In 7 cases with neck tumor, inguinal mass, underarm mass, pelvic mass and supraclavicular mass as the first symptom, upper gastrointestinal bleeding, blood in the stool, abdominal distension and abdominal pain, post-sternal pain, swallowing with fever Sore throat, fever with headache and other onset of 6 cases. Eight patients underwent ART and four patients underwent chemotherapy. 4 cases were not followed up, 7 died. Conclusions If there is unknown reason of HIV infection in patients with lymphadenopathy, fever, gastrointestinal bleeding, the possibility of concurrent lymphoma should be considered, if necessary, lymph node biopsy to confirm the diagnosis. Active ART combined with normative chemotherapy, and the appropriate timing of treatment still need to add more clinical practice information for discussion.