Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases

李　曾; 廖　洪; 谭　政

doi:10.19401/j.cnki.1007-3639.2017.07.010

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Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases

更新时间：2025-12-31

- Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases
- China Oncology Vol. 27, Issue 7, Pages: 581-587(2017)
- 作者机构：
  
  四川省肿瘤医院泌尿外科,四川,成都,610041
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2017.07.010
  CLC：
- Published Online：16 August 2017，
  
  Published：16 August 2017
- 稿件说明：
移动端阅览
李　曾,廖　洪,谭　政,等. 61例原发性肾淋巴瘤临床诊治分析[J]. 中国癌症杂志, 2017, 27(7): 581-587.

李　曾, 廖　洪, 谭　政. Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases[J]. China Oncology, 2017, 27(7): 581-587.
李　曾,廖　洪,谭　政,等. 61例原发性肾淋巴瘤临床诊治分析[J]. 中国癌症杂志, 2017, 27(7): 581-587. DOI： 10.19401/j.cnki.1007-3639.2017.07.010.

李　曾, 廖　洪, 谭　政. Diagnosis and treatment of primary renal lymphoma: an analysis of 61 cases[J]. China Oncology, 2017, 27(7): 581-587. DOI： 10.19401/j.cnki.1007-3639.2017.07.010.

摘要

背景与目的：原发性肾淋巴瘤(primary renal lymphoma，PRL)在临床上较罕见，术前诊断较困难，易误诊为肾癌。该研究旨在总结并探讨PRL的临床分期、病理类型、诊治及预后的特点。方法：回顾性分析国内1981—2014年个案报道的61例PRL患者的临床资料。结果：61例患者中，男性34例(55.7%)，女性27例(44.3%)，男女比例为1.3∶1.0，发病年龄为3~84岁，50~70岁为高发，平均年龄为52.3岁；单侧病变53例(86.9%)，其中左肾34例(64.2%)，右肾19例(35.8%)，双侧病变8例(13.1%)；45例(73.8%)出现腰痛，17例(27.9%)出现发热，8例(13.1%)出现血尿，2例(3.3%)出现急性肾功能衰竭；非霍奇金淋巴瘤(non-Hodgkin’s lymphoma，NHL)58例(95.1%)，占绝大多数，其中B细胞淋巴瘤(B cell lymphoma，BCL)48例(82.8%)，T细胞淋巴瘤(T celllymphoma，TCL)5例(8.6%)，未具体分类5例(8.6%)，以弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma，DLBCL)最常见，为28例(58.3%)，霍奇金淋巴瘤(Hodgkin’s lymphoma，HL)只有1例(1.6%)；47例(77.0%)接受过根治性肾切除手术，48例(78.7%)接受过化疗(其中14例为单纯化疗，34例为术后辅助化疗)，9例(14.8%)接受过放疗；失访1例(1.6%)，未提及预后情况3例(4.9%)，34例(55.7%)病情稳定、存活，但有23例(37.7%)复发、进展，再治疗后，缓解稳定4例(6.6%)，最终死亡19例(31.1%)。结论：PRL临床较罕见、易误诊、恶性程度较高、预后较差，早期行根治性肾切除术、术后联合化疗等综合治疗，有助于减少复发和改善预后。

Abstract

Background and purpose: Primary renal lymphoma (PRL) is rare in clinic

difficult to diagnose preoperatively and easily misdiagnosed as renal cancer. We investigated the clinical pathological characteristics and treatment as well as prognosis of PRL.. Methods: Clinical data from 61 cases of PRL domestic case reports (1981—2014) were obtained and analysed retrospectively. Results: Of the 61 patients

34 cases (55.7%) were men

27 cases (44.3%) were women

the ratio was 1.3∶1.0. The age of onset was between 3 and 84 years with high incidence among patients aged 50 to 70 years

and the average age was 52.3 years. Unilateral lesions were found in 53 cases (86.9%)

of which the left kidney in 34 cases (64.2%)

19 cases (35.8%) of the right kidney. Bilateral lesions were found in 8 cases (13.1%). The signs and symptoms of PRL included back pain in 45 cases (73.8%)

fever in 17 cases (27.9%)

hematuria in 8 cases (13.1%)

acute renal failure in 2 cases (3.3%). There were 58 cases (95.1%) of non-Hodgkin’s lymphoma (NHL)

accounting for the vast majority

of which B cell lymphoma (BCL) in 48 cases (82.6%)

T cell lymphoma (TCL) in 5 cases (8.7%)

not clear in 5 cases (8.7%). Diffuse large B-cell lymphoma (DLBCL) was the most common type (28 cases

58.3%). A total of 47 cases (77.0%) underwent surgery

48 cases (78.7%) received chemotherapy (14 cases of simple chemotherapy

34 cases of postoperative adjuvant chemotherapy)

9 cases (14.8%) underwent radiotherapy. One case (1.6%) was lost to follow-up

and prognosis was not mentioned in 3 cases (4.9%). There were 34 cases (55.7%) in stable condition and survival

23 cases (37.7%) had recurrence and progression

4 cases (6.6%) achieved remission after retreatment

and 19 cases (31.1%) died at last. Conclusion: PRL is a rare tumor with higher malignancy

poorer prognosis as well as easy to misdiagnosis. Radical nephrectomy among patients with early-stage PLR combined with postoperative chemotherapy and other comprehensive treatment

could help to reduce recurrence and improve the prognosis of the disease.

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