Li Xin, Brownlee Noel A, Sporn Thomas A, Mahar Annabelle, Roggli Victor L
From the Department of Pathology, Duke University Medical Center, Durham, North Carolina (Drs Roggli and Sporn); the Department of Pathology, Tianjin Haihe Hospital, Tianjin Institute of Respiratory Diseases, Tianjin, China (Dr Li); the Pathology Associates of Greenville, Greenville, South Carolina (Dr Brownlee); and the Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Mahar).
Arch Pathol Lab Med. 2015 Sep;139(9):1129-36. doi: 10.5858/arpa.2014-0569-OA. Epub 2015 Apr 6.
Ionizing radiation has a role in the development of malignant mesothelioma, in several epidemiologic studies, including patients with hematologic malignancies.
To study the clinicopathologic characteristics of patients with malignant mesothelioma and hematologic malignancies with and without a history of radiotherapy.
From a database of approximately 3600 patients with malignant mesothelioma, we identified 45 patients (1%) who also had hematologic malignancies. We examined clinicopathologic features and noted whether the patient had received radiotherapy for malignancy, comparing those with and those without such exposure.
Among the 45 cases, 18 (40%) had Hodgkin lymphoma, 15 (33%) had non-Hodgkin lymphoma, 10 (4%) had chronic lymphocytic leukemia, and 2 (22%) had chronic myelogenous leukemia; 20 patients (44%) had a history of radiotherapy, and 23 (51%) did not. Most patients with Hodgkin lymphoma (16 of 18; 90.0%) received radiation, whereas none of the patients with leukemia (0 of 12) and only 20% (3 of 15) of the patients with non-Hodgkin lymphoma did so. Patients without radiation were older than patients who received radiotherapy (median, 73 versus 54 years, respectively; P < .001), had a shorter interval from diagnosis of hematologic malignancy to that of mesothelioma (median, 2 versus 24 years, respectively; P < .001), and had a shorter survival period (median, 6.0 versus 14.0 months, respectively; P = .02). Epithelial mesotheliomas were proportionately more common in patients with a history of radiotherapy.
Patients with mesothelioma and hematologic malignancies with a history of radiation tended to be younger, had a longer interval from diagnosis of hematologic malignancy to that of mesothelioma, had a longer survival period, and were more likely to have the epithelial variant compared with patients without radiotherapy.
在包括血液系统恶性肿瘤患者在内的多项流行病学研究中，电离辐射在恶性间皮瘤的发生发展中起作用。
研究有或无放疗史的恶性间皮瘤合并血液系统恶性肿瘤患者的临床病理特征。
从一个约有3600例恶性间皮瘤患者的数据库中，我们识别出45例（1%）同时患有血液系统恶性肿瘤的患者。我们检查了临床病理特征，并记录患者是否因恶性肿瘤接受过放疗，比较有或无此类暴露的患者。
在这45例病例中，18例（40%）患有霍奇金淋巴瘤，15例（33%）患有非霍奇金淋巴瘤，10例（4%）患有慢性淋巴细胞白血病，2例（2%）患有慢性粒细胞白血病；20例患者（44%）有放疗史，23例（51%）没有。大多数霍奇金淋巴瘤患者（18例中的16例；90.0%）接受过放疗，而白血病患者无一例（12例中的0例）接受放疗，非霍奇金淋巴瘤患者中只有20%（15例中的3例）接受放疗。未接受放疗的患者比接受放疗的患者年龄更大（中位年龄分别为73岁和54岁；P <.001），从血液系统恶性肿瘤诊断到间皮瘤诊断的间隔时间更短（中位时间分别为2年和24年；P <.001），生存期更短（中位时间分别为6.0个月和14.0个月；P =.02）。上皮样间皮瘤在有放疗史的患者中比例更高。
与未接受放疗的患者相比，有放疗史的间皮瘤合并血液系统恶性肿瘤患者往往更年轻，从血液系统恶性肿瘤诊断到间皮瘤诊断的间隔时间更长，生存期更长，且更可能有上皮样变体。
