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[淋巴增生性和骨髓增生性疾病中的喉。第二部分:喉部尸检结果与讨论]

[The larynx in lymphoproliferative and myeloproliferative diseases. Part II: Laryngeal autopsy findings and discussion].

作者信息

Horny H P

机构信息

Abteilung für Spezielle Histopathologie und Zytopathologie, Universität Tübingen.

出版信息

HNO. 1994 Jul;42(7):398-404.

PMID:7928429
Abstract

Lymphoreticular neoplasms of the larynx are rare and comprise a heterogeneous group of tumors. A systematic survey of the literature and autoptic evaluation of the larynx in a relatively small number of patients with systemic lymphoreticular malignancies yielded the following findings: Primary tumors of the larynx must be clearly distinguished from laryngeal involvement by systemic or leukemic infiltrations. By far the most common primary hemopoietic tumors of the larynx are extramedullary plasmacytoma (about 90 cases published) and non-Hodgkin's lymphoma (NHL; about 65 cases published). Primary Hodgkin's disease, granulocytic sarcoma and mast cell sarcoma are extremely rare at this site. Plasmacytoma and NHL both preferentially involve the supraglottis. The subglottis is infrequently affected. Laryngeal plasmacytoma and NHL usually present clinically as localized stage IE and IIE tumors that exhibit no significant tendency to recur or generalize. The therapy of choice is local irradiation while chemotherapy should be reserved for recurrent or progressive disease. Prognosis is favourable in most cases of primary laryngeal plasmacytoma and NHL. Secondary involvement of the larynx by systemic lesions or leukemic infiltrations is usually associated with a very poor prognosis. The prognosis of patients with laryngeal involvement in acute or chronic myeloid leukemia is always poor. Although the histopathological diagnoses given in many case reports are often difficult to compare because of differences in terminology, there seems to be a marked preponderance of B-cell tumors of high-grade malignancy (centroblastic or immunoblastic lymphoma in the Kiel classification of NHL) that probably represents lymphomas originating from mucosa-associated lymphoid tissue (MALT).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

喉淋巴网状组织肿瘤较为罕见,是一组异质性肿瘤。对相对少数全身淋巴网状恶性肿瘤患者的文献系统综述及喉部尸检评估得出以下结果:喉原发性肿瘤必须与系统性或白血病浸润所致的喉部受累明确区分。迄今为止,喉最常见的原发性造血肿瘤是髓外浆细胞瘤(约90例已发表病例)和非霍奇金淋巴瘤(NHL;约65例已发表病例)。原发性霍奇金病、粒细胞肉瘤和肥大细胞肉瘤在该部位极为罕见。浆细胞瘤和NHL均优先累及声门上区。声门下区很少受累。喉浆细胞瘤和NHL临床上通常表现为局限性IE期和IIE期肿瘤,无明显复发或播散倾向。首选治疗方法是局部放疗,化疗应留用于复发或进展性疾病。大多数原发性喉浆细胞瘤和NHL病例预后良好。系统性病变或白血病浸润导致的喉部继发性受累通常预后很差。急性或慢性髓系白血病患者喉部受累的预后总是很差。尽管许多病例报告中的组织病理学诊断由于术语差异往往难以比较,但高级别恶性B细胞肿瘤(NHL的基尔分类中的中心母细胞性或免疫母细胞性淋巴瘤)似乎明显占优势,这可能代表源自黏膜相关淋巴组织(MALT)的淋巴瘤。(摘要截选至250词)

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