首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (6): 1067-1073.doi: 10.3969/j.issn.1006-7795.2023.06.024

• 临床研究 • 上一篇    下一篇

以淋巴水肿为首发表现的淋巴瘤的临床分析

郝昆1,孙宇光1,李滨2,信建峰1,张丽3,余春开4,王仁贵5,沈文彬1*   

  1. 1.首都医科大学附属北京世纪坛医院淋巴外科,北京 100038; 2.首都医科大学附属北京世纪坛医院磁共振室,北京 100038; 3.首都医科大学附属北京世纪坛医院核医学科,北京 100038; 4.首都医科大学附属北京世纪坛医院病理科,北京 100038; 5首都医科大学附属北京世纪坛医院放射科,北京100038
  • 收稿日期:2022-12-07 出版日期:2023-12-21 发布日期:2023-12-21
  • 通讯作者: 沈文彬 E-mail:shenwb@bjsjth.cn
  • 基金资助:
    国家自然科学基金项目(61876216),首都医科大学附属北京世纪坛医院院青年基金项目(2022-q16)。

Clinical analysis of lymphoma with lymphedema as the first manifestation

Hao Kun1, Sun Yuguang1, Li Bin2, Xin Jianfeng1, Zhang Li3, Yu Chunkai4, Wang Rengui5, Shen Wenbin1*   

  1. 1.Department of Lymphatic Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 2.Department of MR, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 3.Department of Nuclear Medicine, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 4.Department of Pathology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China; 5.Department of CT, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
  • Received:2022-12-07 Online:2023-12-21 Published:2023-12-21
  • Supported by:
    This study was  supported by National Natural Science Foundation of China(61876216), Youth Fund of Beijing Shijitan Hospital, Capital Medical University (2022-Q16).

摘要: 目的  探讨首发症状为淋巴水肿的淋巴瘤患者的临床特征。方法  选择2010年8月至2022年2月于首都医科大学附属北京世纪坛医院淋巴外科收治的12例以淋巴水肿为首发表现的淋巴瘤患者作为观察组,选择同期于首都医科大学附属北京世纪坛医院淋巴外科收治的20例妇科肿瘤术后的下肢继发性淋巴水肿患者作为对照组。收集2组患者的临床特点,分析以淋巴水肿为首发表现的淋巴瘤患者的临床特征。结果  12例由淋巴瘤引起或加重的淋巴水肿,其中上肢水肿1例、下肢水肿10例、全身性水肿1例。这些患者常伴有虚弱、消瘦、疼痛、肿块、淋巴结肿大等临床症状,肿瘤标志物异常患者比例为6/8,贫血患病率为6/12,超声、电子计算机断层扫描和磁共振成像的阳性率分别为8/8、8/8和3/3,行病理诊断及免疫组织化学检测确诊。2组患者的病程、主要症状及伴随症状、既往史、肿瘤标志物、贫血、影像学检查差异均有统计学意义(P<0.01)。结论  淋巴瘤相关的恶性淋巴水肿少见,发病隐匿。为了避免延误淋巴瘤诊断和治疗,应在随访期间积极寻找淋巴水肿的病因。

关键词: 淋巴水肿, 恶性淋巴水肿, 淋巴瘤, 临床特征

Abstract: Objective  To investigate the clinical features of lymphoma patients with the first symptom of lymphedema. Methods  From August 2010 to February 2022, 12 patients with lymphoma who presentied with lymphedema as the first manifestation were selected as the observation group, and 20 patients with secondary lymphedema of the lower limbs after gynecological tumor surgery were selected as the control group. We collected the clinical characteristics of two groups of patients and analyze the clinical characteristics of lymphoma patients with lymphedema as the first manifestation. Results  There were 12 cases with lymphoedema caused or aggravated by lymphoma, including 1 case with upper limb edema, 10 cases with lower limb edema, and 1 case with systemic edema. These patients are often accompanied by clinical symptoms such as weakness, emaciation, pain, lumps, and enlarged lymph nodes. The proportion of patients with abnormal tumor markers is 6/8, and the prevalence of anemia is  6/12. The positive rates of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) are  8/8, 8/8, and  3/3, respectively. The patients are diagnosed by pathological diagnosis and immunohistochemistry. There were significant differences between the two groups in course of disease, main and concomitant symptoms, past history, tumor markers, anemia, and imaging examinations(P<0.01). Conclusion  Lymphoma associated malignant lymphedema is rare and the incidence is insidious. In order to avoid misdiagnosis and delayed treatment of lymphoma, we should actively identify cause of lymphedema during follow-up.

Key words: lymphedema, malignant lymphedema, lymphoma, clinical characteristics

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