鼻腔原發瀰漫性大B細胞淋巴瘤

Primary Diffuse Large B-cell Lymphoma of the Nasal Cavity

陳咸伸(Hsien-Shen Chen) ； 袁本治(Ben-Chih Yuan) ； 翁慧卿(Hui-Ching Weng) ； 錢尚道(Shang-Tao Chien)

《台灣耳鼻喉頭頸外科雜誌》 42卷6期 (2007/12) Pp. 206-210

https://doi.org/10.6286/2007.42.6.206

摘要

淋巴瘤爲頭頸部少見惡性腫瘤，絕大部分以非哈杰金氏淋巴瘤(non-Hodgkin's lymphoma)爲主。非哈杰金氏淋巴瘤大約佔頭頸部惡性腫瘤的3%~8%左右。有學者指出在西方國家非哈杰金氏淋巴瘤鮮少原發於鼻腔與鼻竇，多以B細胞表現；反觀東方國家與南美則以T細胞或自然殺手細胞爲主，也較常見於鼻腔。雖然致病過程仍不是非常的了解，近年來許多學者認爲與腫瘤基因、染色體異常和病毒感染有關。在治療非哈杰金氏淋巴瘤上，還是根據腫瘤的組織型態、臨床分期及病灶侵犯程度，施以手術治療、放射線治療、化學治療或合併治療，若是早期發現其治療效果更是顯著，甚至可達治癒程度！本科於2006年有一名21歲年輕男性，因左側鼻唇溝(naso-labial groove)位置紅腫熱痛及左側鼻腔呼吸不順來門診就醫，電腦斷層檢查發現在左側鼻腔至上頜竇有一約4cm大小的腫瘤，也有骨頭侵蝕現象；經Caldwell-Luc手術切除後，病理報告證實爲瀰漫性大B細胞淋巴瘤(diffuse large B cell lymphoma, DLBCL)，經整合檢查評估後以Ann Arbor分期爲IE期，主要是以放射線治療後再以化學治療爲主。

關鍵字

瀰漫性大B細胞淋巴瘤 ； 鼻腔

並列摘要

Lymphoma is a rare malignancy involving the head and neck, however, when diagnosed, it is mainly of the non-Hodgkin's type. Non-Hodgkin's lymphomas comprise approximately 3-8% of all malignant head and neck tumors. Some scholars have pointed out that in Western countries non-Hodgkin's lymphomas rarely occur in the nasal cavity and sinus as a primary site, where it is mostly expressed by the B-cell. On the other hand, in Eastern countries and South America, non-Hodgkin's lymphoma is mainly expressed by the T-cell and the natural killer cell, and it is commonly found in the nasal cavity. Even though the pathogenesis process is not fully understood, non-Hodgkin's lymphoma of the head and neck is thought to result from cancer genes, abnormal chromosomes, and viral infections. The treatments for non-Hodgkin's lymphoma are administered according to the organization pattern of the tumor, the clinical stages, and the degree of the invasive lesion. These treatments include surgery, radiation therapy, chemotherapy, or combined therapies. The results of the treatments are remarkable and the disease is curable if discovered in its early stages. A young male of 21 years old came to our hospital in 2006 because of redness, swelling, and local heat in his left naso-labial groove and disturbed breathing. A computed tomography scan demonstrated a 4 cm long tumor, which extended from his left nasal cavity to the maxillary sinus, and bone erosion was also found. After Caldwell-Luc surgery, the pathology report confirmed diffuse large B-cell lymphoma (DLBCL). Through an integrated examination and assessment, it was determined to be stage IE according to Ann Arbor staging, and the main treatment was radiation therapy followed by chemotherapy.

並列關鍵字

diffuse large B cell lymphoma ； nasal cavity