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題 名 | Malignant Lymphomas of Sinonasal Region, Including Cases of Polymorphic Reticulosis: A Retrospective Clinicopathologic Analysis of 34 Cases=包括多形性網織症之鼻腔鼻竇淋巴瘤:34例之回溯性臨床病理分析 |
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作 者 | 楊陽生; 高志平; 張淑美; 林增熙; 何開程; 楊吉雄; | 書刊名 | 中華醫學雜誌 |
卷 期 | 60:5 1997.11[民86.11] |
頁 次 | 頁236-244 |
分類號 | 416.871 |
關鍵詞 | 致命性中線肉芽腫; 鼻腔T/NK細胞淋巴瘤; 非何杰金氏淋巴瘤; 多形性網織症; 鼻腔鼻竇淋巴瘤; Lethal midline granuloma; Nasal T/NK-cell lymphoma; Non-hodgkin's lymphoma; Polymorphic reticulosis; Sinonasal lymphoma; |
語 文 | 英文(English) |
中文摘要 | 背景:鼻腔鼻竇淋巴瘤在西方國家並不常見,而在東方國家較多;我們此一回溯性研究旨在探討分析本院近14年間鼻腔鼻竇淋巴瘤及多形性網織症之臨床病理特徵。 方法:從1982年11月到1996年9月本院共有37例鼻腔鼻竇淋巴瘤,其中34例有足夠的臨床及病理資料可供分析;所有病例有病理切片診斷;我們以淋巴瘤的臨床表徵、組織病理學、治療及病程追蹤加以主評估討論。 結果:這34例鼻腔鼻竇淋巴瘤,男比女比例2.1:1,年齡分佈從13歲至83歲(年齡中位數為60歲),最常見之初發症狀為鼻塞、鼻分泌物及流鼻血,症狀初發開始至病理診斷時間為2個月(中位數),最常犯部位為鼻腔,這34例之病理診斷包括31例非何傑金氏淋巴瘤與3例多形性網織症,其中有13例屬廣泛性大細胞淋巴瘤,14例屬廣泛性混合小大細胞淋巴瘤,4例屬多形性T細胞淋巴瘤;所有病例中有21例經適當之分期:13例為第1期,例為第2期,2例為第3期,2例為第4期;有20例經免疫細胞表型分析:18例(90%)為T細胞,只有2例為B細胞;本研究所涵蓋的時間甚長,給予的治療有相當的差異,但各種單一或混合療法對存活期無統計學上有意義的差別;病程追蹤從9天至130個月不等,平均存活月數為84.2個月,5年存活率為63%。 結論:我們的病例中大多數為T細胞淋巴瘤,大多數的組織病理診斷屬中度惡性淋巴瘤;對於鼻竇淋巴瘤,其治療仍無一致之看法,但適當的局部治療非常重要;原發性鼻腔鼻竇淋巴瘤如能早期診斷,早期給予治療,即使單用局部放射治療仍會有較佳之存活率。 |
英文摘要 | Background: Lymphomas occurring in nasal cavities and paranasal sinuses are uncommon neoplasms in Western, but are reported to be higher in Oriental, countries. A retrospective study was performed to analyze the clinical and pathological characteristics of sinonasal lymphomas/polymorphic reticulosis at Taichung Veterans General Hospital during a 14-year period. Methods: At Taichung Veterans General Hospital, 37 patients with sinonasal lymphomas (including three patients with polymorphic reticulosis) were seen from November 1982 through September 1996. Excluding three patients without sufficient data, a total of 34 patients with their clinical records were reviewed. Clinical information regarding characteristics of the tumors, histological studies, treatment modalities and follow-up was collected for analysis. Results: The 34 patients who underwent review showed a male-to-female ratio of 2.1:1. Median age was 60 years (range 13-83 years). The most common symptoms were nasal obstruction, nasal discharge/rhinorrhea and epistaxis. Median duration of symptoms at the time of diagnosis was two months. The most frequently involved sites were nasal cavities (right more than left side). There were 31 non-Hodgkin's lymphomas and three polymorphic reticuloses. The pathological classifications revealed 13 diffuse large cell lymphomas, 14 diffuse mixed small and large cell lymphomas and four pleomorphic T-cell lymphomas. Of the 21 adequately staged patients, 13 patients were in stage I; four, stage II; two, stage III and two, stage IV. The immunophenotypic study was performed in 20 patients. Eighteen (90%) of them were T-cell lymphomas and only two cases (10%) derived from B-cell. Though approach to therapy and follow-up periods varied during the time period covered by this study, the differences in survival according to treatment modalities were not statistically significant. The follow-up period ranged from 9 days to 130 months. The mean survival was 84.2 months. The overall five-year survival rate was 63%. Conclusions: The majority of the cases here were T-cell lymphomas. Most histologic grading by Working formulation belonged to the intermediate grade. Optimal treatment for such a group of patients still has no consensus, but adequate local control is important. If diagnosed and treated early, primary sinonasal lymphomas can be associated with a favorable outcome even with local treatment alone. |
本系統中英文摘要資訊取自各篇刊載內容。