摘要目的 分析原发乳腺淋巴瘤的临床特征,评估可行的治疗方法.方法 回顾分析2006-2013年间本院收治的34例原发性乳腺淋巴瘤患者临床资料.年龄24~79岁.ⅠE期18例,ⅡE期16例.病理类型包括DLBCL (29例)、间变大细胞淋巴瘤(2例)、边缘区淋巴瘤(2例)、套细胞淋巴瘤(1例).治疗方法单纯手术2例、单纯化疗4例、放化疗5例、手术联合化疗14例、手术联合放化疗9例.采用Kaplan-Meier法计算5年OS、PFS.结果 26例患者存活,8例死亡(其中7例死于淋巴瘤、1例死于化疗相关反应).6例复发患者中5例(83%)发生在疗后2年内,其中1例双乳侵犯患者在经过双侧乳腺切除及化疗后左乳复发,2例骨转移,1例肺及纵隔淋巴结转移,2例皮肤复发.5年OS、PFS率分别为75%、75%.结论 原发性乳腺淋巴瘤是较少见的恶性肿瘤,总体预后尚可,单纯化疗或联合治疗后复发率均较低.对于现有治疗手段治疗后失败者需寻求更有效治疗方法.

abstractsObjective To summarize the clinical characteristics and evaluate the feasible treatments of primary breast lymphoma (PBL).Methods The clinical data of 34 PBL patients (age 24-79 years) who were treated in our hospital between April 2006 and December 2013 were reviewed.Of these 34 patients, 18 had stage ⅠE PBL and 16 had stage ⅡE PBL.Pathological types included diffuse large B cell lymphoma (29 patients), anaplastic large cell lymphoma (2 patients), marginal zone lymphoma (2 patients), and mantle cell lymphoma (1 patient).Two patients underwent surgery, four patients received chemotherapy alone, five patients received chemoradiotherapy, fourteen patients underwent surgery plus chemotherapy, and nine patients underwent surgery plus chemoradiotherapy.The 5-year overall survival (OS) and progression-free survival (PFS) rates were determined by the Kaplan-Meier estimator.Results During follow-up, 26 patients were alive without lymphoma and 8 patients had died by the end of follow-up (7 died from lymphoma and 1 died from chemotherapy-related hepatic failure).Among the 6 patients who relapsed, 5(83.3%) had recurrence within the first 2 years of treatment.In particular, 1 patient who had bilateral breast involvement developed left breast relapse after bilateral mastectomy and chemotherapy, 2 patients had bone marrow metastasis, 1 patient had lung and mediastinal lymph node metastases, and 2 had skin relapse.The 5-year OS and PFS rates of all patients were 75% and 75%, respectively.Conclusions Since PBL is a rare malignancy, its overall prognosis is fair and the incidence of local relapse is low with chemotherapy alone or in combination with other treatments.However, further studies on the development of more effective treatments will be required for patients who have failed the existing treatments.