祖楷文
赣南医科大学
摘要(Abstract):
淋巴瘤是一组起源于淋巴造血系统的恶性肿瘤,骨受累及相关骨质破坏是其比较罕见的临床表现之一,不仅严重影响患者的生活质量,还可能提示疾病的侵袭性生物学行为。由于淋巴瘤骨质破坏的临床症状与影像学表现常与多发性骨髓瘤、实体瘤骨转移等疾病存在重叠,临床误诊率较高。本文对淋巴瘤相关骨质破坏的病理基础、流行病学特征、临床与影像学表现模式、诊断流程以及管理策略展开了系统综述,并深入探讨了当前研究存在的不足之处与未来的发展方向,旨在为临床医生早期识别、精准诊断以 及优化治疗方案提供参考依据。
关键词(KeyWords):
淋巴瘤;骨质破坏;临床特征;诊断;治疗;预后
参考文献(References):
[1] Mitsuy G K ,Bonetti V V ,Pescinini M L S , et al. HIV-related plasmablastic lymphoma causing extensive bone destruction in the mandible. [ J ] .Oral oncology , 2022 , 126105761-105761.
[2] Minako S ,Yukayo T ,Yuko C , et al. Successful treatment of dumbbell-shaped Hodgkin lymphoma with massive sacral bone destruction.[J].Pediatric blood & cancer,2020, 67(5):e28210.
[3]Kanavos,Theofilos,Birbas,Effrosyni,Papoudou-Bai, Alexandra , et al.Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis[J]. Diseases,2023,11(1):42-42.
[4] UMEMURA T ,NAKANO Y ,SOEJIMA Y , et al. Characteristics of Bone Destruction in Cranial Vault Lymphoma Compared with Other Skull Tumors[J].Journal of UOEH,2019, 41(3):335-342.
[5]冯洪燕,涂宁,王科,等.PET/CT 在原发性骨淋巴瘤的诊断及分期中的价值[J].中华全科医学,2023,21(4):650-654.
[6]Sarro, Rossella,Bisig, Bettina,Guey, Baptiste, et al.Follicular Lymphoma Presenting With Symptomatic Bone Involvement: A Clinicopathologic and Molecular Analysis of 16 Cases[J]. Modern Pathology,2024,37(4).
[7]张倩,李新霞.淋巴瘤累及骨髓病理学相关研究进展[J]. 临床医学进展,2023,13(2):2346-2350.
[8]Ghione,Paola,Ahsanuddin,Salma,Luttwak, Efrat, et al.Diffuse large B-cell lymphoma involving osseous sites: utility of response assessment by PET/CT and good long-term outcomes[J]. Haematologica, 2024,109(1):200-208.
[9]Kanavos,Theofilos,Birbas,Effrosyni,Papoudou-Bai, Alexandra , et al.Primary Bone Lymphoma: A Review of the Literature with Emphasis on Histopathology and Histogenesis [J].Diseases,2023,11(1):42-42.
[10]Doma,Andrej,Studen,Andrej,Novakovic,Barbara Jezersek.The Impact of Bone Marrow Involvement on Prognosis in Diffuse Large B-Cell Lymphoma: An 18F-FDG PET/CT Volumetric Segmentation Study[J]. CANCERS,2024,16(22):3762-3762.
[11]Ivanova,Vanesa-Sindi,Davies,John,Menter,Thomas, et al.Primary bone diffuse large B-cell lymphoma(PB-DLBCL): a distinct extranodal lymphoma of germinal centre origin , with a common EZB-like mutational profile and good prognosis [J].Histopathology, 2024,84(3):525-538.