山东大学耳鼻喉眼学报 ›› 2022, Vol. 36 ›› Issue (2): 7-14.doi: 10.6040/j.issn.1673-3770.0.2021.318

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中耳间变性大T细胞淋巴瘤1例并文献复习

赵笑冰,张大为,陈仁杰   

  1. 南京医科大学第二附属医院 耳鼻咽喉头颈外科, 江苏 南京 210000
  • 发布日期:2022-04-15
  • 通讯作者: 陈仁杰. E-mail:renjiechenent@aliyun.com
  • 基金资助:
    江苏省青年医学人才项目(QNRC2016679)

A case of middle-ear anaplastic large T- cell lymphoma and literature review

ZHAO Xiaobing,ZHANG Dawei, CHEN Renjie   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China
  • Published:2022-04-15

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摘要： 目的 探讨中耳间变性大T细胞淋巴瘤的临床特点及诊疗方法,以便对其进行早期诊断。 方法 回顾性分析1例中耳间变性大T细胞淋巴瘤患者的临床资料并复习相关文献进行总结。 结果 淋巴瘤多发生于骨骼、骨髓、皮下组织和脾脏,发生于中耳者罕见。中耳淋巴瘤起病时均无浅表淋巴结肿大,通常表现为耳痛、听力下降及耳内溢液(浆液性、脓性或血性),病情进展,可出现周围性面瘫及颅内外并发症。CT影像学表现可见软组织密度较高且不均匀,骨质破坏不规则、呈虫蚀样,病变范围广,增强扫描可见强化明显。确诊需病理活检及免疫组化,以化学治疗为主。 结论 中耳间变性大T细胞淋巴瘤极为罕见,且临床及影像学表现无特异性,因而详细的病史采集、全身系统检查、病理活检及免疫组化等手段对于早期诊断疾病非常重要。

关键词: 中耳, 肿瘤, 间变性大T细胞淋巴瘤, 免疫组合化学, 耳外科手术

Abstract: Objective To investigate the clinical characteristics, diagnosis and treatment methods of middle ear anaplastic large T-cell lymphoma, to enable its early diagnosis. Methods A patient with middle ear anaplastic large T-cell lymphoma was retrospectively reviewed,along with previous cases of middle ear lymphoma found in the literature. Results Lymphoma mostly occurs in the bones, bone marrow, subcutaneous tissue and spleen, but rarely in the middle ear. There is no superficial lymphadenopathy at the onset of middle ear lymphoma, which usually presents as earache, hearing loss, and ear discharge(serous, purulent, or bloody). Disease progression, peripheral facial nerve paralysis and extra cranial-intracranial complications may occur. The lesion appeared as a high and uneven soft tissue density on the CT and the bone destruction was irregular and worm-eaten. The lesion area was wide and the enhanced scan showed obvious enhancement. Diagnosis requires pathological biopsy and immunohistochemistry. Chemotherapy is the main treatment. Conclusion Middle ear anaplastic large T-cell lymphoma is extremely rare and its clinical and imaging findings are non-specific. Therefore it is imperative to carefully consider the patient’s medical history, systemic examination findings, pathological biopsy findings and immunohistochemistry to diagnose middle ear anaplastic large T-cell lymphoma at an early stage.

Key words: Middle ear, Tumor, Anaplastic large T cell lymphoma, Immunocombination chemistry, Otology surgery

中图分类号: 

  • R764.92
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