Chetty R, Slavin J L, O'Leary J J, Ansari N A, Gatter K C
University Department of Cellular Science, University of Oxford.
Pathology. 1995 Apr;27(2):111-4. doi: 10.1080/00313029500169672.
Three cases of Hodgkin's disease presenting primarily in the lung are described. All 3 patients presented with respiratory symptoms and chest X-rays revealed discrete masses within the lung parenchyma. CT examination of the mediastinum did not reveal regional or generalized lymphadenopathy at the time of diagnosis in 2 of the cases. A diagnosis of Hodgkin's disease was made on open lung biopsies and despite aggressive chemotherapy, 2 patients died within 2 yrs. The histological and immunocytochemical features of these cases were typical of that expected in Hodgkin's disease. However, the stated indolent course of primary pulmonary Hodgkin's disease is not invariable. Those patients with bilateral interstitial disease and systemic symptoms have a poor prognosis. Furthermore, it is difficult to exclude definitely lymph node involvement (although not enlarged) at the time of diagnosis. Since several cases described in the literature have concurrent and/or subsequent nodal involvement, the entity of primary pulmonary Hodgkin's disease without lymph node involvement is exceedingly rare.
本文描述了3例以肺部为主要首发部位的霍奇金淋巴瘤病例。所有3例患者均有呼吸系统症状，胸部X线显示肺实质内有孤立性肿块。其中2例患者诊断时纵隔CT检查未发现区域或全身性淋巴结肿大。经开放性肺活检确诊为霍奇金淋巴瘤，尽管进行了积极的化疗，仍有2例患者在2年内死亡。这些病例的组织学和免疫细胞化学特征符合霍奇金淋巴瘤的典型表现。然而，原发性肺霍奇金淋巴瘤所述的惰性病程并非一成不变。那些有双侧间质性疾病和全身症状的患者预后较差。此外，诊断时很难明确排除淋巴结受累（尽管未肿大）。由于文献中描述的几例病例有同时和/或随后的淋巴结受累情况，无淋巴结受累的原发性肺霍奇金淋巴瘤极为罕见。
