中国实用内科杂志

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以胸腔积液为首发表现的非霍奇金淋巴瘤8例临床分析并文献复习

彭雅婷欧阳若芸陈平肖奎   

  1. 作者单位:中南大学湘雅二医院呼吸内科,长沙 410011
  • 出版日期:2014-12-01 发布日期:2014-12-19
  • 通讯作者: 欧阳若芸
  • 基金资助:

    国家临床重点专科建设项目经费资助

Non-Hodgkin’s lymphoma firstly manifested as pleural effusion:eight cases of report and literature review

PENG Ya-tingOUYANG Ruo-yunCHEN PingXIAO Kui.   

  1. Department of Respiratory Medicine,the Second Xiangya Hospital,Central South University,Changsha 410011,China
  • Online:2014-12-01 Published:2014-12-19

摘要:

目的 探讨以胸腔积液为首发表现的非霍奇淋巴瘤(non-Hodgkin lymphoma,NHL)患者的临床特点及诊断方法。方法 回顾性分析8例NHL患者的临床资料,结合文献复习并讨论。结果 8例临床表现不具特异性。7例行内科胸腔镜检查,镜下可见弥漫性胸膜充血肿胀或苍白、多个小结节样病变、血管显露、增粗迂曲及胸膜增厚粘连等表现。2例行纤维支气管镜检查,其中1例支气管黏膜肿胀肥厚。6例经胸膜活检确诊,1例经纵隔镜活检淋巴结确诊,1例经外科手术切除肺叶确诊。6例接受化疗药物治疗,1例接受手术治疗,1例接受对症治疗,随访时仅1例存活。结论 经内科胸腔镜胸膜活检有利于首发症状为胸腔积液的淋巴瘤的诊断。

关键词: 非霍奇金淋巴瘤, 胸腔积液, 胸腔镜

Abstract:

Abstract:Objective To explore the clinical characteristics and diagnosis of patients with non-Hodgkin lymphoma (NHL) firstly manifested as pleural effusion.Methods The clinical data of 8 NHL patients were analyzed retrospectively and discussed with literature review.Results Clinical features of the 8 patients were non-specific.Medical thoracoscopy was performed in 7 patients,showing diffused pleural congestion,swelling or pale,multiple nodules,tortuous and engorged vessels,and pleural thickening and adhesions.Flexible fiberoptic bronchoscopy was performed in 2 patients,showing almost normal morphology in 1 case and swelling and hypertrophy of bronchial mucosa in the other case.Six patients were diagnosed by thoracoscopic biopsies,1 patient by mediastinoscopic lymph node biopsies and the rest one by surgical lobectomy.As for treatments,1 patient received only surgery and 1 case received only palliative care,while the other 6 cases underwent only chemotherapy.Only 1 patient remained alive during follow-up.Conclusion Medical thoracoscopic pleural biopsies are helpful in diagnosis of NHL firstly manifested as pleural effusion.

Key words: non-Hodgkin lymphoma, pleural effusion, thoracoscopy

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