本文選題：淋巴瘤　切入點(diǎn)：宮頸　出處：《廣西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的通過1例原發(fā)性宮頸淋巴瘤(LUCX)的臨床病例報(bào)道,并對(duì)國內(nèi)外文獻(xiàn)報(bào)道的病例進(jìn)行復(fù)習(xí),總結(jié)該疾病的臨床特點(diǎn)和診療方案,以提高對(duì)該疾病的認(rèn)識(shí)。方法報(bào)道了我院診治的1例原發(fā)性LUCX病例,并在PubMed、萬方、中國知網(wǎng)、維普數(shù)據(jù)庫上檢索2002年到2016年報(bào)道的病例,進(jìn)行臨床總結(jié)。結(jié)果本文報(bào)道的1例原發(fā)性LUCX病例,55歲女性,絕經(jīng)后不規(guī)則陰道流血,婦檢見右側(cè)宮頸外生型菜花樣腫物,病理活檢診斷為彌漫大B細(xì)胞淋巴瘤。行根治性子宮切除術(shù)+雙側(cè)附件切除術(shù)+盆腔淋巴結(jié)清掃術(shù)+腹主動(dòng)脈旁淋巴結(jié)切除術(shù),術(shù)后隨訪16個(gè)月未見復(fù)發(fā)。本文回顧了以往報(bào)道的原發(fā)性LUCX病例,總結(jié)臨床特點(diǎn)如下:(1)59例患者的發(fā)病年齡分布在22~85歲,平均46.7歲;(2)大部分(67.8%)的患者主要癥狀為陰道流血,其余少部分患者表現(xiàn)為宮頸腫物、陰道排液和胃腸道癥狀等;(3)大部分患者就診時(shí)為早期,70.8%為Ann Arbor IE期,50%為FIGO IB期;(4)所有患者病理類型均為非霍奇金淋巴瘤(NHL),其中88.1%為B細(xì)胞來源,8.5%為T細(xì)胞來源;(5)94.9%的患者采用化療或化療為基礎(chǔ)的綜合治療;(6)59例患者中,生存期最短為6個(gè)月,最長超過180個(gè)月,6例死亡,其中2例IE期,2例IIE期,2例IVE期。結(jié)論原發(fā)性LUCX是臨床罕見病,好發(fā)于絕經(jīng)前期,病理類型以DLBCL最常見,該病經(jīng)早期診斷和治療后預(yù)后良好,但由于該病臨床癥狀無特異性,容易造成漏診和誤診。該病目前尚無標(biāo)準(zhǔn)的治療方案,以化療為基礎(chǔ)的綜合治療是最常用的治療手段。臨床分期是影響預(yù)后的最主要因素。
[Abstract]:Objective to report a case of primary cervical lymphoma (LUCX) and review the cases reported in the literature at home and abroad, and summarize the clinical features and diagnosis and treatment of the disease. Methods A case of primary LUCX was reported in our hospital. Results A case of primary LUCX was reported in a 55-year-old female with irregular postmenopausal vaginal bleeding. Diffuse large B-cell lymphoma was diagnosed by pathological biopsy. Radical hysterectomy, bilateral appendage resection, pelvic lymph node dissection, para-aortic lymphadenectomy, There was no recurrence after 16 months of follow-up. The clinical features of the previously reported cases of primary LUCX were summarized as follows: the age distribution of the onset of primary LUCX was 22 to 85 years old (mean 46.7 years old), and the main symptom of the patients was vaginal bleeding. A small number of other patients presented with cervical neoplasms, Vaginal effusion and gastrointestinal symptoms (70.8%, Ann Arbor IE, 50%, FIGO IB) all the pathological types were non-Hodgkin 's lymphoma, of which 88.1% were B cell origin (8.5%, T cell origin, 594.9%). Of the 659 patients who were treated with chemotherapy or chemotherapy-based comprehensive therapy, The shortest survival time was 6 months, and the longest death was over 180 months in 6 cases, of which 2 cases were in IE stage and 2 cases in IIE stage and 2 cases in IVE stage. Conclusion Primary LUCX is a rare clinical disease, which is prone to premenopausal stage. DLBCL is the most common pathological type. The prognosis of the disease is good after its early diagnosis and treatment, but it is easy to cause missed diagnosis and misdiagnosis due to the lack of specificity of clinical symptoms. Chemotherapy-based comprehensive therapy is the most commonly used treatment, and clinical staging is the most important factor affecting prognosis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33

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