頭頸部瀰慢性大B細胞淋巴癌－病例報告

Diffuse Large B Cell Lymphoma of Head and Neck Region-Case Report

鄭仁昌(Jen-Chan Cheng) ； 施嘉霖(Jia-Lin Shih) ； 許博智(Po-Chih Hsu) ； 邵子齡(Tzu-Ling Shao) ； 夏毅然(Yi-Jan Hsia)

《中華民國口腔顎面外科學會雜誌》 17卷2期 (2006/09) Pp. 128-138

https://doi.org/10.7104/CJOMS.200609.0128

摘要

淋巴癌是原發位置不明的惡性腫瘤，它可發生於全身任何一個淋巴結或是淋巴組織，甚至可侵犯非淋巴組織之器官。而在頭頸部的惡性腫瘤中淋巴癌並不多見，約佔頭頸部癌症的3.5%。
本報告提出一50歲男性病例，因右側下顎骨角處腫大至本院求診。檢查發現右側顎下腺分有一腫塊，手術取出腫瘤後，病理診斷為非典型性淋巴組織增生(atypical lymphoid hyperplasia)。半年後，腫瘤複發合併左側扁桃脈腫大。從扁桃腺做切片，病理診斷為瀰漫性大B細胞淋巴癌(diffuse large B cell lymphoma)。病人接受化學治療，目前結束第二次療程，腫瘤已消散。後續仍需密切追蹤，以防腫瘤復發。
本報告將進一步提出如何鑑別診斷發生於頭頸部之腫瘤，除了常見之頭頸部良性、惡性腫瘤及唾液腺疾病外，亦不可忽略其它較少見疾病。即使病理切片顯示為良性病變，亦有可能是惡性病灶之前兆，因此持續之追蹤觀察是非常必要的。

關鍵字

瀰漫性大B細胞淋巴癌 ； 頭頸部淋巴結 ； 頸部腫塊

並列摘要

Lymphoma is one type of malignant tumor with an uncertain primary site, occurring in a lymph node or in lymphoid tissues throughout the body. Lymphoma is uncommon in the head and neck, accounting for roughly 3.5% of malignant neoplasms in this region. We report a 50-year-old patient who presented to our department with a mass over the right submandibular region. After an excisional biopsy, atypical lymphoid hyperplasia was diagnosed. In the next six months, a recurrent mass was noted accompanied by swelling of the left tonsil. After an incisional biopsy from the left tonsil, diffuse large B cell lymphoma was diagnosed. By the end of a second course of chemotherapy with, the mass had disappeared completely. We use this case as a basis for discussion of the differential diagnosis of head and neck tumors, as well as treatment and prognosis of diffuse large B cell lymphoma.

並列關鍵字

Diffuse large B cell lymphoma ； Head and neck lymph node ； Neck mass