鼻和咽部原发性非霍奇金淋巴瘤17例临床分析

doi:10.6040/j.issn.1673-3770.0.2017.199

摘要/Abstract

摘要： 目的总结鼻和咽部原发性非霍奇金淋巴瘤的临床特点,提高及时确诊率。方法回顾性分析收治的资料完整并经病理确诊的原发性鼻和咽部非霍奇金淋巴瘤17例的临床资料。结果鼻腔和鼻窦非霍奇金淋巴瘤患者首发症状包括鼻塞、流涕、鼻出血和外鼻畸形。鼻咽部非霍奇金淋巴瘤患者表现为耳鸣和听力下降,口咽部非霍奇金淋巴瘤患者表现为咽部异物感、咽痛、吞咽困难等。鼻和咽部原发性非霍奇金淋巴瘤临床表现无特异性,新生物表面有大量坏死组织,对可疑患者需要局麻或全麻下反复活检。结论鼻和咽部原发性非霍奇金淋巴瘤临床症状多不典型,易造成误诊、漏诊,及时行病理活检是确诊鼻和咽部原发性非霍奇金淋巴瘤的主要手段。

关键词: 鼻腔, 鼻咽, 非霍奇金淋巴瘤, 口咽

Abstract: Objective To analyze the clinical characteristics of primary non-Hodgkins lymphoma in the nose and pharynx. Methods The clinical data of 17 patients with pathologically confirmed non-Hodgkins lymphoma of the nose and pharynx were retrospectively reviewed. Results Six patients with non-Hodgkins lymphoma in the nasal cavity and paranasal sinuses showed nasal obstruction, nasal discharge, bloody rhinorrhea, malformation of the external nose, or hearing loss. Four patients with nasopharyngeal non-Hodgkins lymphoma presented with tinnitus and hearing loss. Seven patients with non-Hodgkins lymphoma in the oropharynx reported foreign body sensation in the throat, pharyngalgia, and dysphagia. The clinical manifestations of primary non-Hodgkins lymphoma in the nose and pharynx were non-specific. There was a large amount of necrotic tissue covering the surface of the neoplasm. In three patients, a biopsy was performed more than once before non-Hodgkins lymphoma was confirmed. Conclusion Diagnosis of primary non-Hodgkins lymphoma in the nose and pharynx is often missed. An accurate diagnosis is best achieved by pathological biopsy.

Key words: Nasal cavity, Nasopharynx, Oropharynx, Non-Hodgkins lymphoma

中图分类号:

R739.6

秦贺,胡斌,叶京英. 鼻和咽部原发性非霍奇金淋巴瘤17例临床分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(4): 51-53.

QIN He, HU Bin, YE Jingying. Clinical analysis of 17 patients with primary non-Hodgkins lymphoma in the nose and the pharynx.[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(4): 51-53.

参考文献

[1] Salplahta D, Comanescu MV, Anghelina F, et al.Non-Hodgkin lymphomas of Waldeyers ring [J]. Rom J Morphol Embryol, 2012, 53(4):1057-1060.
[2] Cheson BD, Horning SJ, Coiffier B, et al. Report of an international workshop to standardize response criteria for non-Hodgkins lymphomas [J]. Clin Onc, 1999, 17(4):1244-1253.
[3] Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification [J]. J Clin Oncol, 2014, 32(27):3059-3068.
[4] Niemiec M, Stryjewska-Makuch G, Janik M, et al. Head and neck lymphomas-a retrospective ten-year observation [J]. Contemp Oncol(Pozn), 2017, 21(1):66-69.
[5] Geng L, Wang X. Epstein-Barr Virus-associated lymphoproliferative disorders: experimental and clinical developments [J]. Int J Clin Exp Med, 2015, 8(9):14656-14671.
[6] Wang J, Cai CP, He SF, et al. Characteristics and prognostic factors for head and neck non-Hodgkin's lymphoma in Chinese patients [J]. J Laryngol Otol, 2013, 127(7):699-704.
[7] 李少玲,付骞千,张甜甜,等. 原发性胃肠道非霍奇金淋巴瘤的临床特征及预后因素分析[J]. 肿瘤防治研究,2017,44(1): 28-33. LI Shaoling, FU Qianqian, ZHANG Tiantian,et al. Clinical features and prognostic factors of primary gastrointestinal non-Hodgkin's lymphoma[J]. Cancer Res Prev Treat, 2017, 44(1): 28-33.
[8] 孙志强,李卓江,景本年. 鼻咽部非霍奇金淋巴瘤误诊为鼻咽癌3例[J]. 中国煤炭工业医学杂志,2004,7(10): 989.
[9] 张岚,常英展. 鼻咽部恶性淋巴瘤误诊为纤维血管瘤1例[J]. 临床肿瘤学杂志,2001,6(3): 268.
[10] 张丽,魏斌宏,贺玉良. 非霍奇金淋巴瘤误诊茎突综合征合并淋巴结炎一例[J]. 包头医学, 2016,40(3):187-188.
[11] 张玲,陶兴罡. 扁桃体恶性淋巴瘤误诊的警示/反思(附1例报告)[J]. 中国伤残医学, 2014, 22(10):104-105.
[12] Li CC, Tien HF, Tang JL, et al. Treatment outcomes and pattern of failure in 77 patients with sinonasal natural killer/T-cell or T-cell lymphoma [J]. Cancer, 2004, 100(2): 366-375.
[13] Giridhar P, Mallick S, Bhasker S, et al. Head and neck extra nodal NHL(HNENL)-Treatment Outcome and Pattern of failure-A Single Institution Experience [J]. Asian Pac J Cancer Prev, 2015, 16(15):6267-6272.

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