原发性脾肿瘤25 例临床分析
Diagnosis and Treatment of 25 Cases of Primary Splenic Tumors
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摘要: 目的 探讨原发性脾肿瘤临床特点及其治疗. 方法 回顾性分析1991年1月至2003年12月中国医学科学院肿瘤医院收治的25例原发性脾肿瘤患者的临床表现、影像学特点、诊断依据和治疗预后资料. 结果 25例原发性脾肿瘤均行脾切除术,其中11例良性病变包含脾表皮样囊肿、脾血管瘤各3例,脾炎性假瘤2例,脾错构瘤、脾假性囊肿、脾肉芽肿性病变各1例;14例恶性肿瘤包含脾原发性非何杰金氏淋巴瘤10例,血管肉瘤4例.随访,良性肿瘤患者均无复发;10例非何杰金氏淋巴瘤,除1例术后14个月死于复发外,4例分别随访18月、19月、41月和45月未发现复发和转移,5例随访超过4年仍健在,其中1例存活已达11年2个月.4例脾血管肉瘤中分别于手术后7月、9月、28月因肿瘤转移而死亡,1例随访16个月未见复发和转移. 结论 原发性脾肿瘤以手术治疗为主,良性肿瘤效果好;原发性非何杰金淋巴瘤结合辅助治疗预后好,恶性肉瘤预后差,早期诊断、早期治疗是唯一希望.Abstract: Objective To study the clinical characteristics and t reatment of primary splenic tumors. Methods 25 patient s with primary splenic neoplasm diagnosed at surgery from January 1991 to December 2003 were analyzed ret rospectively. Results 11 cases of benign splenic tumors incliding 3 cases of splenic true cyst, 3 cases of hemagioma, 2 cases of inflammatory seudotumor, 1 each of epidermoid cyst 、hamartoma and asestoma. There were 14 cases of malignant tumor, among which, there were 10 cases of non-Hodgkin's lymphoma and 3 cases of angiosarcoma and 1 case of angioepitheliosarcoma. Conclusion Splenectomy is the t reatment of choice for primary splenic tumors and surgery is satisfactory in benign tumors. Non-Hodgkin' s lymphoma requires adjuvant therapy. Prognosis of angiosarcoma is bad. Early diagnosis and early therapy are crucial to improving the prognosis of primary splenic malignancy.
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