Solitary Primary Chest Wall Lymphoma-Report of a Case

原發性胸壁淋巴瘤：病例報告

蘇英傑(Ying-Chieh Su) ； 馮瑤(Yao Fong) ； 郭進榮(Jinn-Rung Kuo) ； 蔡岳峰(Yueh-Feng Tsai)

《胸腔醫學》 24卷6期 (2009/12) Pp. 346-351

https://doi.org/10.29806/TM.200912.0007

摘要

原發性胸壁腫瘤並不常見，只佔所有的胸腔腫瘤之5%，而原發性胸壁淋巴癌又未合併其他區域之侵犯則相當少見，統計上只佔了原發性胸壁腫瘤的2.4%，並且幾乎都發生在50至60歲的年齡層。對於原發性淋巴癌之治療，該採手術廣泛性切除併胸壁重建或化學治療，何者有較佳之預後，目前仍無定論。
在此，我們介紹一個原發性胸壁淋巴癌的年輕女性，因考量手術切除併重建之破壞，將影響病患之身體機能及外觀，且化學治療也可能得到良好之療效，故採行化學治療。病患在完成6個M-CHOP的治療週期之後，已追蹤4年時間，腫瘤未再復發。

關鍵字

淋巴瘤 ； 胸壁腫瘤 ； 胸壁淋巴瘤 ； 胸壁腫瘤手術

並列摘要

Primary chest wall lymphoma is a rare condition. We report a 32-year-old woman who developed an asymptomatic right chest wall mass. Chest computed tomography (CT) showed destruction of the right 8th rib, associated with a huge extra-osseous soft tissue mass (6×5 cm) in the right chest wall. CT-guided fine needle biopsy showed diffuse, large B-cell lymphoma. The patient received 6 courses of chemotherapy with M-CHOP (methotrexate, cyclophosphamide, doxorubicin, vincristine, and prednisolone) over the course of 3 months. A Tc-99m MDP (PET CT) after chemotherapy showed no Tc-99m MDP uptake throughout her body, including the prior tumor site. After about 4 years of follow-up, chest CT-imaging revealed no tumor recurrence. In our experience, chemotherapy alone may lead to total regression of the tumor, followed by a long period of disease-free survival. Chemotherapy should be considered as the initial therapy for patients with primary chest wall lymphoma. Partial or total regression of the tumor could make surgery easier, or avoidable.

並列關鍵字

lymphoma ； chest wall tumor ； chest wall lymphoma ； surgery for chest wall tumor ； M-CHOP