Sica Antonello, Santagata Mario, Sagnelli Caterina, Rambaldi Piero, Franco Renato, Creta Massimiliano, Vitiello Paola, Caccavale Stefano, Tammaro Vincenzo, Sagnelli Evangelista, Ronchi Andrea
Department of Precision Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Multidisciplinary Department of Medical Surgery and Dental Specialties, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Healthcare (Basel). 2021 Mar 5;9(3):286. doi: 10.3390/healthcare9030286.
Lymphomas usually involve lymph nodes and other lymphoid tissues, but sometimes occur in non-lymphoid organs, called extra-nodal sites. Primary diffuse extra-lymph node large B-cell lymphoma (DLBCL) of the thyroid and parotid gland have been observed rarely. According to the most accredited guidelines, primary extra-nodal DLBCL of the parotid and thyroid glands should be treated with three cycles of R-CHOP followed by radiotherapy of the involved site (ISRT). Surgery alone is not enough to treat DLBCL. We describe two unusual cases of primary extra-nodal DLBCL in elderly patients treated exclusively with surgical resection, given the inability to apply chemotherapy. Both patients achieved clinical recovery, which was maintained after a follow-up of more than 18 months, despite not having performed the indicated chemotherapy protocol. The two cases presented here, and a few others reported in the literature, should be considered exceptions to the rule, and do not allow the conclusion that surgery alone might be sufficient for complete remission.
淋巴瘤通常累及淋巴结和其他淋巴组织，但有时也会发生在非淋巴器官，即所谓的结外部位。甲状腺和腮腺的原发性弥漫性结外大B细胞淋巴瘤（DLBCL）很少见。根据最权威的指南，腮腺和甲状腺的原发性结外DLBCL应采用三个周期的R-CHOP方案治疗，随后对受累部位进行调强适形放疗（ISRT）。单纯手术不足以治疗DLBCL。我们描述了两例老年原发性结外DLBCL的特殊病例，由于无法进行化疗，仅接受了手术切除治疗。尽管未执行指定的化疗方案，但两名患者均实现了临床康复，在随访超过18个月后仍保持康复状态。此处介绍的这两个病例以及文献中报道的其他一些病例，应被视为该规则的例外情况，不能由此得出仅手术就足以实现完全缓解的结论。
