摘要
目的 探讨原发性卵巢弥漫大B细胞淋巴瘤(primary ovarian diffuse large B-cell lymphoma,PODLBCL)的临床病理学特征、诊断、治疗及预后。方法 回顾性分析2003年1月至2021年1月首都医科大学附属北京朝阳医院收治的4例PODLBCL患者的临床资料并进行文献复习。结果 4例PODLBCL患者均经术后组织病理学诊断,临床症状以盆腔肿块、腹痛为主;合并B症状2例,双侧卵巢肿瘤2例,单侧肿瘤2例(均发生在右侧卵巢),CA125、乳酸脱氢酶(LDH)均呈高表达3例。镜下表现为卵巢正常结构破坏,被相对单一形态的、体积较大的淋巴细胞弥漫性浸润。细胞质常嗜碱性,细胞核呈圆形或卵圆形,单个或多个核仁;核分裂象多见;CD20染色阳性。治疗包括手术、化疗和单克隆抗体治疗,经随访2~238个月后,无复发存活3例,死亡1例。结论 PODLBCL是罕见的弥漫大B细胞淋巴瘤,临床表现无特异性,诊断依赖于术后病理组织学检查,预后较好。化疗联合单克隆抗体治疗可为一线治疗方案,以避免手术,但术前明确诊断很关键。
ObjectiveTo investigate the clinicopathological characteristics, diagnosis, treatment and prognosis of primary ovarian diffuse large B-cell lymphoma(PODLBCL).MethodsThe clinical data of 4 patients with PODLBCL admitted to Beijing Chao-yang Hospital, Capital Medical University from January 2003 to January 2021 were retrospectively analyzed and the literature was reviewed.ResultsThe 4 cases of PODLBCL patients were diagnosed by postoperative histopathology. The main clinical symptoms were pelvic masses and abdominal pain;2 cases with B symptoms, 2 cases with bilateral ovarian tumors, 2 cases with unilateral tumors(both occurred in the right ovary) and 3 cases with high expression of CA125 and lactate dehydrogenase(LDH). Microscopically, the normal ovary was destroyed and diffusely infiltrated by relatively single and large lymphocytes. The cytoplasm was usually basophilic, and the nucleus was round or oval, with single or multiple nucleoli;mitotic figures were common, and CD20 staining was positive. The treatment included surgery, chemotherapy and monoclonal antibody treatment. After 2-238 months of follow-up, 3 patients survived without recurrence and1 patient died.ConclusionsPODLBCL is a rare diffuse large B-cell lymphoma with no specific clinical manifestation. The diagnosis depends on postoperative histopathology, and the prognosis is good. Chemotherapy combined with monoclonal antibody therapy may be the first-line treatment option to avoid surgery, but a definitive diagnosis before surgery is critical.
作者
张雪芳
刁小莉
王淑珍
ZHANG Xuefang;DIAO Xiaoli;WANG Shuzhen(Department of Gynaecology and Obstetrics,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China;2Department of Pathology,Beijing Chao-yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中国癌症防治杂志》
CAS
2022年第6期653-658,共6页
CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT
