頭頸部結外性惡性淋巴瘤

Extranodal Malignant Lymphoma of the Head and Neck

周承良(Chen-Lien Chou) ； 張燕良(Yen-Liang Chang)

《中華民國耳鼻喉科醫學會雜誌》 29卷2期 (1994/04) Pp. 93-100

https://doi.org/10.6286/1994.29.2.93

摘要

頭頸部為惡性淋巴瘤的好發部位之一。而發生於淋巴結外的組織與器官的結外性惡性淋巴瘤，在發生部位;、臨床表現、組織病理形態等方面與淋巴結性淋巴瘤大不相同，實為兩個各具特色的疾病實體。我們收集臺大醫院自1982年1月至1991年12月這十年間的頭頸部結外性惡性淋巴瘤共有166例，經過分析整理發現最常發生的部位是Waldeyer氏環(Waldeyer’s ring)，其次是竇鼻部，若更細分其原發的解剖部位，則以腭扁桃為最常見，比率為37.3%，其次為鼻腔，占有25.9%。在臨床症狀方面，與各原發部位的惡性瘤相當類似，無法由此來做鑑斷。在組織病理方面，全部都是屬於非杰金氏淋巴瘤(non-Hodgkin’s lymphoma)，且病理亞型以瀰漫性大細胞型(diffuse large cell type)為最多，且我們的系列中低惡性度者較少見。而依據Ann Arber staging system 所做的臨床分期顯示我們的早期病例偏低。而在治療方面，我們列表比較早、近期不同理念的治療方式。最後我們並檢討比較淋巴瘤在治療後產生第二種惡性腫瘤的機率是否提高。

關鍵字

非何杰金氏淋巴瘤

並列摘要

The head and neck region is one of the most common sites of extranodal malign-nant lymphoma. We collected 166 cases of extranodal malignant lymphomal of the head and neck between January 1982 and December 1991. By the way of chart reviewing retrospectively, we analyzed and re-evaluated the clinical data. The average age was 52.5 years and male to female ratio was 1.77:1. The most common site of involvement was Waldeyer’s ring, followed by the sino-nasal part. Histologically, all cases were non-Hodgkin’s lymphomal and diffuse large cell type the most common histopathological subtype. It is hard to differentiate malignant lymphoma from carcinoma of the same anatomical site merely by clinical symptoms. In compare-son with other reports, less cases of early sage in our study should remind us making early diagnosis. The treatment modality was also reviewed and compared with the therapy of current concept.

並列關鍵字

non-Hodgkin's lymphoma