文章摘要
原发性子宫大B细胞淋巴瘤一例报告及文献复习
Primary uterine large B cell lymphoma: a case report and literature review
投稿时间:2019-12-25  修订日期:2020-01-12
DOI:
中文关键词: 淋巴瘤  子宫  恶性  手术治疗
英文关键词: Lymphoma  Uterus  Malignant  Surgical treatment
基金项目:
作者单位邮编
成九梅* 首都医科大学附属北京妇产医院 100006
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中文摘要:
      目的: 总结原发性子宫恶性淋巴瘤的临床表现、影像及病理学特点,以期提高对原发性子宫恶性淋巴瘤的认识及诊治水平。方法:通过PubMed、万 方、维普、中国知网数据库检索2001年1月至2018年8月报道的原发性子宫恶性淋巴瘤的文献,结合首都医科大学附属北京妇产医院收治的1例原发性子宫大B细胞淋巴瘤的病例资料,对此类患者临床表现、影像及病理学特点、治疗方案及预后进行总结。结果:患者女,64岁,发现盆腔肿物半月伴有绝经后阴道流血,盆腔CT提示:宫体与宫颈局部巨大团块状软组织密度灶,宫底及宫体上段可见内膜。宫腔镜下组织活检病理:(宫内物)符合低分化恶性肿瘤,结合免疫组化结果,诊断原发性子宫大B细胞淋巴瘤。行开腹全子宫及双侧附件、大网膜及腹膜后淋巴结清扫术,术后计划给予CHOP方案化疗六程,现已完成两程。结论:原发性子宫恶性淋巴瘤极为少见,临床表现缺乏特异性,难以与子宫其他恶性肿瘤区分。病灶多位于宫颈,很少累及子宫内膜,组织学上以B 细胞淋巴瘤为主,影响学检查常选择盆腔CT及MRI,病理学诊断需要结合免疫组化确诊。该疾病恶性程度高,治疗上以根治性手术为主,化疗为辅,预后较差。
英文摘要:
      Objective: To improve the diagnosis and treatment of primary uterine malignant lymphoma. Methods: The literature on primary uterine malignant lymphoma reported from January 2001 to August 2018 was searched by PubMed, Wanfang Med Online, VIP date base and China National Knowledge Infrastructure, and combined with a primary disease admitted to Beijing Obstetrics and Gynecology Hospital affiliated to Capital Medical University. Case data of uterine large B-cell lymphoma were summarized, and the clinical manifestations, imaging and pathological features, treatment options and prognosis of these patients were summarized. Results: A 64 years old female, complaint with vaginal bleeding after menopause, pelvic CT prompt: cervical and lower uterine segment was invaded by massive soft tissue, the fund of the uterus and the endometrial was normal. Hysteroscopic biopsy confirmed as primary uterine large B cell lymphoma. Dissection of the whole uterus and bilateral annexes, omentum and retroperitoneal lymph node was done, complied with CHOP chemotherapy postoperatively. Conclusion: Primary uterine malignant lymphoma is extremely rare. Its histopathology mainly consists of B-cell lymphoma with high degree of malignancy. Radical surgery is the main treatment and chemotherapy is supplemented. The prognosis of such diseases is poor.
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