目的:探讨腹膜后肿块为首发症状的恶性淋巴瘤的临床特点、治疗及预后.方法:回顾性收集自2002年1月至2010年12月间收治的20例腹膜后肿块为首发症状的恶性淋巴瘤患者的临床资料,分析其病理活检方式、病理类型、免疫组化、分期、治疗效果、生存率等.研究手术、年龄、性别、分期、巨大包块、B症状、病理类型对近期疗效的影响.结果:20例患者中11例(55%)为弥漫大B细胞性淋巴瘤,4例(20%)为滤泡性淋巴瘤,2例(10%)为小淋巴细胞性淋巴瘤/慢性淋巴细胞白血病,1例(5%)为淋巴母细胞性淋巴瘤,1例(5%)为间变细胞淋巴瘤,1例(5%)霍奇金淋巴瘤.全组患者化疗后完全缓解7例(35%),部分缓解8例(40%);5例就诊后3个月之内早期死亡,9例起病后4～36个月之间疾病进展或复发死亡.全组患者中5年生存率仅20%.手术、病理类型、年龄、大包块、浸润周围器官广泛、静脉血栓形成、肝功能异常、B症状对近期疗效有明显影响.结论:腹膜后肿块为首发症状的恶性淋巴瘤缓解率和长期生存率较低,预后差.病理类型、手术、大包块、浸润周围器官、肝功能异常、静脉血栓形成、B症状对缓解率和长期生存率有明显影响.%Objective: To investigate the clinical characteristics,treatment outcomes and prognostic factors of patients with malignant lymphoma with primary retroperitoneal mas as the primary presentation. Methods: A total 20 cases of malignant lymphoma with primary retroperitoneal presentation lymphoma seen in our hospital from January 2002 to Decemter 2010 Biopsy method , tissue pathology, immunochemistry,treatmemt outcome and long time survival were analyzed retrospectively. The influences of age, sex, pathologic type, clinical stage, huge mass and B symptom were analyzed. Results: Among the 20 cases, 11 ( 55 % ) were diffuse large B cell lymphoma, 4 ( 20 % )were follicular lymphoma, 2 ( 10 % ) were B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma, 1 ( 5% ) was lymphoblastic lymphoma, 1 ( 5 % ) was anaplastic large cell lymphoma and 1 ( 5 % ) was Hodgkin lymphoma. Among the 20 cases, 7 ( 35 % ) had complete remission , 8 ( 40 % ) had partial remission, 5 ( 25 % ) died. The 3-year accumulated survival of the whole group was 30 %,The 5-year accumulated survival of the whole group was only 20%. Conclusion: Complete remission rate and long term survival rates of malignant lymphoma with primary retroperitoneal presentation were low. Pathological type, surgery, huge mass, B symptom, hepatic deysfunction,and infiltrating surrounding organs significantly affect long term survival.
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