Ferraro P, Trastek V F, Adlakha H, Deschamps C, Allen M S, Pairolero P C
Department of Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Ann Thorac Surg. 2000 Apr;69(4):993-7. doi: 10.1016/s0003-4975(99)01535-0.
Primary non-Hodgkin's lymphoma of the lung is a rare entity. Although the prognosis is favorable, clinical features, prognostic factors, and patient management have not been clearly defined.
We reviewed retrospectively the records of 48 patients operated on for primary pulmonary non-Hodgkin's lymphoma. The study group consisted of 21 male (44%) and 27 female (56%) patients with a mean age of 61.8 years. Thirty-seven and a half percent of patients were asymptomatic, and 62.5% were seen with pulmonary symptoms, systemic symptoms, or both. A definitive diagnosis was obtained by thoracotomy in 90% of patients, thoracoscopy in 8%, and anterior mediastinotomy in 2%.
Complete surgical resection was possible in 19 patients (40%). A mucosa-associated lymphoid tissue lymphoma (MALT) was found in 35 patients and lymphoma that was not of this type, in 13. The 1-year, 5-year, and 10-year survival rates were 91%, 68%, and 53%, respectively in the group with mucosa-associated lymphoid tissue lymphoma and 85%, 65%, and 64% in the group with lymphoma that was not of the mucosa-associated lymphoid tissue type. None of the prognostic factors studied (mode of presentation, smoking history, bilateral disease, postoperative stage, complete resection, adjuvant chemotherapy, histology) significantly influenced patient survival.
Primary non-Hodgkin's lymphoma of the lung occurs with nonspecific clinical features. Although patient survival is good, prognostic factors could not be identified.
原发性肺非霍奇金淋巴瘤是一种罕见疾病。尽管预后良好,但临床特征、预后因素及患者管理尚未明确界定。
我们回顾性分析了48例接受原发性肺非霍奇金淋巴瘤手术患者的病历。研究组包括21例男性(44%)和27例女性(56%)患者,平均年龄61.8岁。37.5%的患者无症状,62.5%的患者有肺部症状、全身症状或两者皆有。90%的患者通过开胸手术确诊,8%通过胸腔镜检查确诊,2%通过前纵隔切开术确诊。
19例患者(40%)可行完整手术切除。35例患者发现黏膜相关淋巴组织淋巴瘤(MALT),13例为非此类淋巴瘤。黏膜相关淋巴组织淋巴瘤组的1年、5年和10年生存率分别为91%、68%和53%,非黏膜相关淋巴组织型淋巴瘤组分别为85%、65%和64%。所研究的预后因素(表现方式、吸烟史、双侧病变、术后分期、完整切除、辅助化疗、组织学)均未对患者生存产生显著影响。
原发性肺非霍奇金淋巴瘤临床表现不具特异性。尽管患者生存率良好,但无法确定预后因素。