Primary Laryngeal Lymphoma-Case Report

原發性喉部淋巴癌－病例報告

張耘甄(Yun-Chen Chang) ； 林婉妮(Wan-Ni Lin)

《台灣耳鼻喉頭頸外科雜誌》 53卷3期 (2018/09) Pp. 101-110

https://doi.org/10.6286/jtohns.201809_53(3).101

摘要

BACKGROUND: Primary non-Hodgkin lymphoma of larynx accounts for less than 1% of all laryngeal neoplasms. As far as we know, there are fewer than 50 cases which have been reported in English literature. MATERIAL AND METHODS: This study was a retrospective chart review of three patients diagnosed laryngeal lymphoma in the Department of Otolaryngology at the Chang Gung Memorial Hospital, Linkou Medical Center from 2010 to 2017. Also, cases that presented in the English literature from 1995 to 2017 were included. The records were analyzed for age, gender, type, appearance location, symptoms at presentation, treatment, comorbidity and complication, disease status, follow up duration. RESULT: MALT lymphoma is the most common type of B cell origin lymphoma in larynx, with diffuse large B cell lymphoma coming in second. Other types of lymphoma are extremely rare. Though treatment options remain controversial, limited stage lymphomas tend to be treated with radiotherapy, and advanced stage lymphomas are mostly treated with chemotherapy. Combination of radiotherapy and chemotherapy has not been proven to be effective. The role the surgical intervention is to reduce the size of tumor, to release mass effect and clinical obstructive symptoms as a conclusion of our all analysis. CONCLUSION: To our knowledge, there are no treatment protocol published to date in the English literature, so we would like to share our experience of laryngeal lymphoma in our department, and also the presented cases in English literature review. Perhaps our study will help to shed more light on this rare yet noteworthy disease.

關鍵字

primary laryngeal lymphoma

並列摘要

背景：原發性的喉部淋巴瘤是非常罕見的，約佔所有喉部腫瘤的1%。就我們所知，過去全球英文文獻報告中只有不到50例的病例報告。方法：我們採用回溯性的方法，回顧7年區間（2010年1月至2017年12月），單一醫學中心－林口長庚紀念醫院耳鼻喉部的癌症登記中，3例關於原發性的喉部非何杰金氏淋巴瘤的病例。我們統計了這3例病患的資料，包括病患年紀，腫瘤型態、外觀、位置，症狀，治療，共病與併發症，疾病狀態，後續追蹤時間。另外，也回顧了已發表的英文文獻中，過去22年間（1995至2017），原發性喉部淋巴瘤病例的資料統計。結果：經過統計，喉部的原發性淋巴瘤以黏膜相關淋巴組織淋巴瘤為最常見的種類，第二常見的則是瀰漫性大B細胞淋巴瘤。目前的治療指引中並沒有一定的標準治療流程。統計指出，前期的原發性淋巴瘤較常以單一放射治療為主，而晚期的則以化學治療為主。手術的角色，則以減積，減少腫瘤壓迫的併發症，以及減緩病患症狀為主。結論：我們希望能透過此篇論文，同時分享林口長庚醫學中心對於此病症的治療方法，也同時回顧過去的前人經驗，期未來對此罕見病症有更多的掌握與了解。

並列關鍵字

primary laryngeal lymphoma（原發性喉部淋巴癌）