牙龈弥漫性大B细胞淋巴瘤2例

doi:10.7518/hxkq.2024.2023240

摘要/Abstract

摘要：

发生在口腔牙龈的弥漫性大B细胞淋巴瘤（DLBCL）非常少见，易被误诊及误治。本文报道了2例口腔牙龈DLBCL，并结合2008—2023年间国内、外报道的21例牙龈DLBCL的文献，对其临床病理特征、诊断及鉴别诊断进行讨论。

Abstract:

Diffuse large B-cell lymphoma (DLBCL) in the oral gums is very rare and is prone to misdiagnosis and mistreatment. In this paper, 2 cases of oral gingival DLBCL were reported. Their clinicopathological features, diagnosis, and differential diagnosis were discussed based on the literature of 21 cases of gingival DLBCL reported at home and abroad from 2008 to 2023.

Key words: gingiva, diffuse large B-cell lymphoma, clinicopathological

中图分类号:

R739.8

李国莉, 娄镜, 谭娜, 郑洪. 牙龈弥漫性大B细胞淋巴瘤2例[J]. 华西口腔医学杂志, 2024, 42(2): 256-261.

Li Guoli, Lou Jing, Tan Na, Zheng Hong. Gingival diffuse large B-cell lymphoma: report of 2 cases[J]. West China Journal of Stomatology, 2024, 42(2): 256-261.

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参考文献 23

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参考文献病例/	性别/年龄（岁）	部位及临床特征	B症状	乳酸脱氢酶	影像学	肿瘤大小/cm	Ann Arbor分期	治疗	预后/月
1/[5]	F/57	牙龈溃疡	/	正常	/	2.5	ⅠE期	RT	ANED/79
2/[5]	F/65	牙龈溃疡	/	升高	/	3.5	ⅠE期	R-CHOP+RT	ANED/13
3/[5]	F/68	牙龈溃疡	/	正常	/	3.5	ⅠE期	CHOP+RT	ANED/22
4/[5]	M/60	牙龈溃疡	/	正常	/	2	ⅠE期	R-CHOP+RT	ANED/16
5/[5]	F/68	/	/	升高	/	>5	ⅠE期	/	/
6/[5]	M/62	牙龈溃疡	/	正常	/	2，多个	ⅠE期	R-CHOP	ANED/19
7/[5]	M/76	牙龈溃疡	/	正常	/	4	ⅠE期	R-THP-COP+RT	ANED/33
8/[5]	F/72	/	/	正常	/	3	ⅠE期	/	/
9/[5]	F/62	牙龈溃疡	/	升高	/	1.5	ⅠE期	CHOP+RT	ANED/177
10/[5]	F/77	牙龈溃疡	/	正常	/	3.5	ⅠE期	部分切除+CHOP	ANED/31
11/[5]	M/57	/	/	正常	/	3	ⅡE期	R-CHOP	ANED/52
12/[10]	M/73	左下颌牙龈肿痛伴溃疡	/	/	CT显示左下颌到左牙槽区软组织阴影	1.5	ⅠE期	R-THP-COP	ANED/36
13/[11]	M/53	牙龈肿痛	/	正常	/	/	ⅠE期	R-CHOP	ANED/18
14/[12]	M/51	牙龈肿痛	/	正常	/	/	/	R-CHOP+RT	死亡/59
15/[13]	M/43	左下颌牙龈肿痛	无	/	X线片显示弥漫性骨透射线	3		CHOP	ANED/6
16/[14]	M/63	右上颌牙龈肿痛	/	/	/		Ⅱ期	RT	死亡/29
17/[14]	F/69	左上颌牙龈肿物	/	/	/		Ⅲ期	CHOP+RT	死亡/6
18/[15]	M/61	右上颌牙龈肿物伴溃烂	无	/	MRI显示右上牙龈区团块影	3	/	化疗	/
19/[16]	M/84	右上颌牙龈肿物	无	正常	X线显示上颌团块影	0.4	ⅠE期	未治疗	消退/24
20/[17]	F/61	右上颌牙龈肿痛	/	正常	/	/	/	未治疗	消退/22
21/[18]	M/67	右下颌牙龈肿痛	无	/	CT显示软组织密度影	/	/	化疗	ANED/12
病例1	M/79	右下颌牙龈溃疡	无	/	CT提示软组织稍增厚	1.5	/	未治疗	死亡/12
病例2	M/83	右上颌牙龈肿物	无	/	/	5	/	未治疗	死亡/1

病例/参考文献	EBER	CD3	CD5	CD10	CD20	CD138	BCL6	MUM1	Ki-67/%	分型
1/[5]	-	-	-	-	+	-	-	+	85	ABC
2/[5]	+	-	-	-	+	-	-	+	75	ABC
3/[5]	-	-	-	-	+	-	-	+	60	ABC
4/[5]	-	-	-	-	+	-	-	+	90	ABC
5/[5]	-	-	-	+	+	-	+	-	80	GCB
6/[5]	+	-	-	-	+	-	+	+	70	ABC
7/[5]	-	-	-	-	+	-	+	+	80	ABC
8/[5]	-	-	-	+	+	-	+	+	50	GCB
9/[5]	-	-	-	-	+	-	+	+	65	ABC
10/[5]	-	-	-	-	+	-	+	+	80	ABC
11/[5]	-	-	-	-	+	-	-	+	90	ABC
12/[10]	-	-	-	-	+	-	+	+	90	ABC
13/[11]	/	/	/	/	+	/	/	/	/	/
14/[12]	/	-	/	-	+	/	+	+	70	ABC
15/[13]	/	-	/	-	+	/	+	-	60	GCB
16/[14]	-	-	-	+	+	/	+	+	90	GCB
17/[14]	-	-	-	+	+	/	+	-	90	GCB
18/[15]	/	-	/	-	+	-	-	+	70	ABC
19/[16]	-	-	/	/	+	/	/	/	90	/
20/[17]	-	-	-	-	+	/	+	-	90	GCB
21/[18]	/	-	-	-	+	-	-	+	60	ABC
病例1	/	-	-	+	+	-	+	+	90	GCB
病例2	-	-	-	-	+	/	+	+	90	ABC

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