原發性鼻腔T細胞淋巴瘤

根據統計，在非何杰金氏淋巴癌中，約有20%至30%的比例是屬於結節外型。這些結節外淋巴癌中，主要以腸胃道，耳鼻喉及皮膚為三大主要發病部位。然而，東西方的結節外淋巴癌表現卻明顯各有不同之處；在西方國家主要是以腸胃道侵犯為主，而東方國家包括台灣在內則是以耳鼻喉部淋巴癌居多。而非何杰金氏淋巴癌的病理分類及臨床分期的確定，更可用以做為一個完整的治療計畫的依據，使得淋巴癌能在所有惡性腫瘤的治療領域中，成為少數對放射治療或合併化學治療後有相當成效者。因此，耳鼻喉部結節外淋巴癌在台灣地區的重要性，值得我們做為1名耳鼻喉科醫師對此疾病更加重視，進而能夠早期診斷與治療。本科於1999年經歷1名59歲女性，因左側鼻腔長期阻塞及鼻出血至本科求診，電腦斷層檢查發現左側下鼻甲後端，出現一2cm左右腫瘤。經切除後，病理報告證實為廣泛性大型T細胞淋巴癌，術後經其他檢查以Ann Arbor分期方式確定屬於第IE期。給予局部之放射治療後，追蹤至今2年半，無腫瘤復發現象且鼻腔通氣功能良好。

關鍵字

惡性淋巴癌；結節外；鼻腔

並列摘要

Among the patients of non-Hodgkin's lymphoma, a proportion of about 20% to 30% belonging to extranodal type. For these patients with extranodal lymphoma, the three most affected sites are: the gastrointestinal tract, the head and neck region, and the skin. In the Western countries, the disease predominately affect the gastrointestinal tract; but in Eastern countries, including Taiwan, this disease most often presented in the head and neck area. The pathological classification of non-Hodgkin's lymphoma and the confirmation of clinical staging are references for formulating treatment plan, and many such lymphoma patients achieve effective results with radiotherapy or combined chemotherapy. Therefore, otolaryngologists should be more aware of the importance of extranodal lymphoma in Taiwan area to allow earlier diagnosis and treatment. In 1999, a 59-year-old woman patient with long-term obstruction and epistaxis of the left nasal cavity, sought assistance from our department. Clinical exam and C.T. scan showed 2-cm tumor at the posterior left inferior turbinate. After excision of the tumor, the pathological report proved that it was diffuse large type T-cell lymphoma. According to Ann Arbor staging, the disease was classified as IE stage. Local radiotherapy was prescribed and the patient is disease free after two-and-a-half years of follow up and the nasal passage remains patent.

並列關鍵字

malignant lymphoma ； extranodal ； nasal cavity

國際替代計量

原發性鼻腔T細胞淋巴瘤

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