Bailey R L, Laws H L
Department of Surgery, Carraway Methodist Medical Center, Birmingham, AL 35234.
Am Surg. 1989 Nov;55(11):665-8.
A retrospective review revealed 17 lymphomas in a 25-year period (1960-84). Presenting features did not allow differentiation from carcinoma. Preoperative diagnosis was made in 3 patients by endoscopic biopsy. Treatment included apparent complete resection of 12 patients. Incomplete removal following biopsy with or without a drainage procedure was performed on five patients. Radiation therapy was used on ten patients and chemotherapy was used on three patients. There were three 5-year survivors and four others with survival greater than 2 years. All patients surviving more than 2 years had apparent complete resection while five patients also had radiation. One also had chemotherapy. Analysis of our patients with review of other series suggests complete resection with adjacent nodes to be the best approach. Appropriate node sampling, liver biopsy, and removal of the spleen if it appears clinically involved should be done. Postoperative radiation and/or chemotherapy may be indicated only when apparent complete resection is not feasible.
一项回顾性研究显示，在25年期间（1960 - 1984年）共发现17例淋巴瘤。临床表现无法与癌相鉴别。3例患者术前通过内镜活检得以确诊。治疗方法包括12例患者进行了明显的根治性切除。5例患者在活检后进行了不完全切除，有的还进行了引流手术。10例患者接受了放射治疗，3例患者接受了化疗。有3例患者存活了5年，另外4例患者存活时间超过2年。所有存活超过2年的患者均进行了明显的根治性切除，其中5例患者还接受了放射治疗。1例患者还接受了化疗。对我们的患者进行分析并回顾其他系列研究表明，连同相邻淋巴结进行根治性切除是最佳方法。应进行适当的淋巴结采样、肝活检，若脾脏在临床上疑似受累则应予以切除。仅当明显的根治性切除不可行时，才可能需要术后放疗和/或化疗。
