3例原发性甲状腺滤泡性淋巴瘤的临床分析及文献复习

doi:10.3969/j.issn.1009-976X.2023.05.009

岭南现代临床外科 ›› 2023, Vol. 23 ›› Issue (05): 418-423.DOI: 10.3969/j.issn.1009-976X.2023.05.009

3例原发性甲状腺滤泡性淋巴瘤的临床分析及文献复习

蔡雷琴¹, 黄楚霖^1#, 余君言¹, 孙侃¹, 严励¹, 王晓艺¹, 徐明彤¹, 张锦¹, 吴木潮¹, 胡宇坤², 任萌^1,*

1.广东省代谢性疾病（糖尿病）临床医学研究中心/中山大学孙逸仙纪念医院内分泌科,广州 510120;
2.中山大学孙逸仙纪念医院病理科,广州 510120

通讯作者: *任萌,Email：renmeng80@139.com
作者简介:#共同第一作者
基金资助:
国家自然科学基金青年项目（82000784）; 广东省代谢性疾病（糖尿病）临床医学研究中心（2020B1111170009）

Clinical analysis of 3 cases primary thyroid follicular lymphoma and literature review

CAI Lei-qin¹, HUANG Chu-lin^1#, YU Jun-yan¹, SUN Kan¹, YAN Li¹, WANG Xiao-yi¹, XU Ming-tong¹, ZHANG Jin¹, WU Mu-chao¹, HU Yu-kun², REN Meng^1,*

1. Guangdong Clinical Medical Research Center for Metabolic Diseases （Diabetes Mellitus）/Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China;
2. Department of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China

Received:2023-08-25 Online:2023-10-20 Published:2023-12-27
Contact: REN Meng, renmeng80@139.com
About author:# Co-first author

摘要/Abstract

摘要： 目的探讨原发性甲状腺滤泡性淋巴瘤（PTFL）的临床表现、病理学特征、免疫表型、鉴别诊断、治疗及预后。方法回顾性分析3例患者术后病理诊断考虑为PTFL的临床资料,整理并分析治疗方案及随访预后。结果 3例均行手术治疗。1例术后病理诊断明确,规律化疗,随访3年余,完全缓解;1例术后病理诊断尚不明确,不支持经典的滤泡性淋巴瘤,但不排除Bcl-2阴性的PTFL,未行进一步检查和化疗,随访6年余,疾病稳定;1例病理诊断困难,经过病理专科会诊后确诊,行1程CD20单克隆抗体治疗后随访1年余,完全缓解。结论 PTFL在临床上并不多见,容易误诊和漏诊。通过收集3例PTFL进行临床分析,提供鉴别诊断思路,并为其制定个体化临床治疗策略提供依据。

关键词: 甲状腺, 滤泡性淋巴瘤, 病理诊断, 治疗, 预后

Abstract: Objective To explore the clinical manifestations, pathological features, immunophenotype, differential diagnosis, treatment and prognosis of primary thyroid follicular lymphoma （PTFL）. Methods The clinical data of three patients with PTFL were retrospectively analyzed, and the therapy strategy and follow-up prognosis were sorted out and analyzed. Results All three patients underwent surgery. One of them was confirmed as FL by pathological diagnosis, and regular chemotherapy after surgery. This patient was followed up for more than 3 years and completely remission （CR）. The postoperative pathological diagnosis of other one was not clear, for the results didn't support typical FL. However, the Bcl-2-negative PTFL couldn't be exclude. This case was in stable condition after followed up for more than 6 years without any further examination or chemotherapy. The last case had difficulties in pathological diagnosis, and finally diagnosed as FL by pathology specialist consultation. Then the patient was treated with 1 course CD20 monoclonal antibody and followed up for over 1 year, CR. Conclusion PTFL is rare in clinical practice and is prone to misdiagnosed or missed. By collecting 3 cases of PTFL for clinical analysis, the differential diagnosis ideas were provided and the basis for formulating individualized clinical treatment strategies were provided.

Key words: thyroid, follicular lymphoma, pathological diagnosis, therapy, follow-up

中图分类号:

R736.1

蔡雷琴, 黄楚霖, 余君言, 孙侃, 严励, 王晓艺, 徐明彤, 张锦, 吴木潮, 胡宇坤, 任萌. 3例原发性甲状腺滤泡性淋巴瘤的临床分析及文献复习[J]. 岭南现代临床外科, 2023, 23(05): 418-423.

CAI Lei-qin, HUANG Chu-lin, YU Jun-yan, SUN Kan, YAN Li, WANG Xiao-yi, XU Ming-tong, ZHANG Jin, WU Mu-chao, HU Yu-kun, REN Meng. Clinical analysis of 3 cases primary thyroid follicular lymphoma and literature review[J]. Lingnan Modern Clinics In Surgery, 2023, 23(05): 418-423.

参考文献

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3例原发性甲状腺滤泡性淋巴瘤的临床分析及文献复习

Clinical analysis of 3 cases primary thyroid follicular lymphoma and literature review

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