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[颌骨原发性骨淋巴瘤的临床特征及影像学分析]

[Clinical features and imaging analysis of primary bone lymphoma of the jaw].

作者信息

Peng Y H, Wang S J, Zhao J F, Zha Z A, Han X G, Sun Q, Sun M L

机构信息

Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Zhonghua Kou Qiang Yi Xue Za Zhi. 2020 Jun 9;55(6):383-387. doi: 10.3760/cma.j.cn112144-20200105-00003.

Abstract

To investigate the clinical characteristics and imaging manifestations of primary bone lymphoma (PBL) located in the jaw. Clinical data of 14 PBL patients admitted to The First Affiliated Hospital of Zhengzhou University from January 2014 to April 2019 were retrospectively analyzed, which including age, gender, location, chief complaint, laboratory test, imaging manifestations and so on. Among the 14 PBL patients, 10 were male and 4 were female. Age range from 4 to 79 years, median age was 56 years old. There were 6 cases involved maxillary, 7 cases involved mandible and 1 case involved mandible and maxillary simultaneously. Twelve patients were admitted with local mass as the chief complaint, 3 had a history of toothache, 4 had loosen tooth and 2 had numbness of lips and cheeks. Two cases of oral mass with mucosal surface ulcer or abscess formation. One case complained of fever, night sweats and other systemic symptoms. The imaging findings showed 8 cases of osteolytic lesions, 1 case of sclerosis, 4 cases of mixed lesions and 1 case of cystic lesions. One case had periosteum reaction. In 12 cases, there was an obvious mass, which was characterized by the large soft-tissue mass and marrow changes were associated with surprisingly little cortical destruction. PBL is more common in middle aged male. The upper and lower jaw bones can be involved. Clinical and imaging manifestations lack characteristics, and common dental or periodontal symptoms such as toothache, tooth loosening, and paresthesia may occur. However, the imaging characteristics of large soft tissue masses with small degree of bone destruction can be used as an important basis for the differential diagnosis of osteomyelitis, squamous cell carcinoma, osteosarcoma and other diseases.

摘要

探讨颌骨原发性骨淋巴瘤(PBL)的临床特征及影像学表现。回顾性分析2014年1月至2019年4月郑州大学第一附属医院收治的14例PBL患者的临床资料,包括年龄、性别、部位、主诉、实验室检查、影像学表现等。14例PBL患者中,男性10例,女性4例。年龄范围为4至79岁,中位年龄为56岁。上颌骨受累6例,下颌骨受累7例,下颌骨和上颌骨同时受累1例。12例以局部肿块为主诉入院,3例有牙痛病史,4例牙齿松动,2例有唇颊麻木。2例口腔肿块伴有黏膜表面溃疡或脓肿形成。1例主诉有发热、盗汗等全身症状。影像学表现为溶骨性病变8例,硬化性病变1例,混合性病变4例,囊性病变1例。1例有骨膜反应。12例有明显肿块,其特点是软组织肿块大,骨髓改变明显但皮质破坏较少。PBL多见于中年男性。上下颌骨均可受累。临床及影像学表现缺乏特征性,可出现牙痛、牙齿松动、感觉异常等常见的牙齿或牙周症状。然而,软组织肿块大而骨破坏程度小的影像学特征可作为与骨髓炎、鳞状细胞癌、骨肉瘤等疾病鉴别诊断的重要依据。

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