Hughes Marie, Morrison Anne, Jackson Robert
Department of Haematology, Western Infirmary, Glasgow, UK.
Leuk Lymphoma. 2005 Jun;46(6):873-7. doi: 10.1080/10428190500079829.
Primary bladder non-Hodgkin's lymphoma (NHL) is rare. Optimal management remains controversial. Using the Scotland and Newcastle lymphoma group database, 12 patients with primary bladder lymphoma were identified between 1980 and 2001, the largest single group of patients available to date. Histology and immunocytochemistry was reviewed in 9 of the 12 cases. Six cases were low-grade extranodal marginal zone lymphoma, 4 diffuse large B-cell lymphoma, one an ALK 1 positive anaplastic large cell lymphoma (ALKoma) and one a low-grade lymphoma unspecified. Two patients (low-grade NHL) were treated with oral antibiotics (n=1) or diathermy (n=1) alone with complete resolution of disease. One patient with high-grade NHL gained complete remission without conventional therapy. Nine patients were treated with single or combined modality surgery, chemotherapy and/or radiotherapy. Overall survival was 75%, mean follow up of 4.8 (range 1-10) years. A review of 88 additional cases in the literature support the findings that primary bladder lymphoma is associated with a good prognosis. Patients with low-grade extranodal marginal zone lymphoma may respond well to simple therapies. Patients with diffuse large B-cell lymphoma respond well to first-line chemotherapy regimens. Ureteric obstruction and acute renal failure are serious complications. Repeat cystoscopy is mandatory for follow-up.
原发性膀胱非霍奇金淋巴瘤（NHL）较为罕见。最佳治疗方案仍存在争议。利用苏格兰和纽卡斯尔淋巴瘤小组数据库，在1980年至2001年间确定了12例原发性膀胱淋巴瘤患者，这是迄今为止最大的单组患者群体。对12例中的9例进行了组织学和免疫细胞化学检查。6例为低级别结外边缘区淋巴瘤，4例为弥漫性大B细胞淋巴瘤，1例为ALK 1阳性间变性大细胞淋巴瘤（ALKoma），1例为未明确的低级别淋巴瘤。2例患者（低级别NHL）仅接受口服抗生素治疗（n = 1）或透热疗法（n = 1），疾病完全缓解。1例高级别NHL患者未经传统治疗即获得完全缓解。9例患者接受了单一或联合方式的手术、化疗和/或放疗。总生存率为75%，平均随访4.8年（范围1 - 10年）。对文献中另外88例病例的回顾支持了原发性膀胱淋巴瘤预后良好的研究结果。低级别结外边缘区淋巴瘤患者可能对简单治疗反应良好。弥漫性大B细胞淋巴瘤患者对一线化疗方案反应良好。输尿管梗阻和急性肾衰竭是严重并发症。随访时必须重复进行膀胱镜检查。
