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3.概念延伸 4.参考文献
弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma, DLBCL)是非霍奇 [1] Morton LM, Wang SS, Devesa SS, et al. Lymphoma incidence
金淋巴瘤(non-Hodgkin lymphoma, NHL)中最常见的组织学亚型，在NHL病 patterns by WHO subtype in the United States, 1992-2001. Blood 2006;
例中约占25%[1-3]。 107:265.
DLBCL患者通常表现为快速增大的症状性肿块，最常为颈部或腹部淋巴结 [2] Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the
增大，或者原发纵隔大B细胞淋巴瘤的纵隔淋巴结肿大，但也可表现为身体任 World Health Organization classification of lymphoid neoplasms. Blood
意部位的肿块。约30%的患者发生全身性B症状(即，发热、体重减轻和大量盗 2016; 127:2375.
汗)，超过半数的患者血清乳酸脱氢酶(lactate dehydrogenase, LDH)升高[4, [3] WHO Classification of Tumours of Haematopoietic and
5]。高达40%的病例可起于结外髓外组织，原发性结外病变最常见于消化道 Lymphoid Tissues, revised 4th edition, Swerdlow SH, Campo E, Harris
[6]。 NL, et al. (Eds), International Agency for Research on Cancer (IARC),
DLBCL常常是根据组织活检结果来诊断，最常用的标本为切除的浅表淋巴 Lyon 2017. 1. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian
结。尽管大多数患者都在诊断中首选浅表淋巴结切除活检，但部分患者没有浅 J Med Res 2004; 120(4):316-53.
表淋巴结肿大，因此需要用深部淋巴结组织，或者其他组织(如胸腹水、脾脏 [4] Armitage JO, Weisenburger DD. New approach to classifying
等)进行病理评估。 non-Hodgkin's lymphomas: clinical features of the major histologic
本例患者肝功示LDH轻度升高，无浅表淋巴结肿大，最终通过对腹腔肝门 subtypes. Non-Hodgkin's Lymphoma Classification Project. J Clin Oncol
部淋巴结行EUS-FNA确诊，考虑淋巴瘤确诊需要较多的组织条行免疫组化， 1998; 16:2780.
穿刺选用的19G针。 [5] A clinical evaluation of the International Lymphoma Study
Group classification of non-Hodgkin's lymphoma. The Non-Hodgkin's
Lymphoma Classification Project. Blood 1997; 89:3909.
[6] Møller MB, Pedersen NT, Christensen BE. Diffuse large B-cell
lymphoma: clinical implications of extranodal versus nodal
presentation--a population-based study of 1575 cases. Br J Haematol
2004; 124:151.

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