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目的探讨以胸腔积液为首发表现的非霍奇淋巴瘤(non-Hodgkin lymphoma,NHL)患者的临床特点及诊断方法。方法回顾性分析8例NHL患者的临床资料,结合文献复习并讨论。结果 8例临床表现不具特异性。7例行内科胸腔镜检查,镜下可见弥漫性胸膜充血肿胀或苍白、多个小结节样病变、血管显露、增粗迂曲及胸膜增厚粘连等表现。2例行纤维支气管镜检查,其中1例支气管黏膜肿胀肥厚。6例经胸膜活检确诊,1例经纵隔镜活检淋巴结确诊,1例经外科手术切除肺叶确诊。6例接受化疗药物治疗,1例接受手术治疗,1例接受对症治疗,随访时仅1例存活。结论经内科胸腔镜胸膜活检有利于首发症状为胸腔积液的淋巴瘤的诊断。
Objective To investigate the clinical features and diagnosis of non-Hodgkin lymphoma (NHL) with pleural effusion as the first manifestation. Methods The clinical data of 8 patients with NHL were retrospectively analyzed and reviewed. Results The clinical manifestations of 8 cases were not specific. Seven cases of medical thoracoscopy, microscopic examination showed diffuse pleural congestion or pale, multiple small nodular lesions, vascular revealed thickening tortuous and pleural thickening adhesions and other performance. 2 cases of bronchoscopy, swollen hypertrophy in 1 case of bronchial mucosa. 6 cases were diagnosed by pleural biopsy, 1 case was diagnosed by mediastinoscopy biopsy lymph node, 1 case was diagnosed by surgical removal of lung lobe. 6 received chemotherapy, 1 received surgery, 1 received symptomatic treatment and only 1 survived at follow-up. Conclusion The medical thoracoscopic pleural biopsy is helpful for the diagnosis of pleural effusion lymphoma.