关键词：甲状腺肿瘤/外科学；淋巴瘤/外科学
【摘要】 目的 评价外科手术在甲状腺淋巴瘤处理中的作用。方法 14例甲状腺淋巴瘤患者中，行细针穿刺1例，切取活检4例，甲状腺腺叶切除8例，全甲状腺切除1例。单纯放疗4例，单纯化疗2例，放疗加化疗7例，术后拒绝放化疗1例。结果 1例穿刺细胞学无分类，13例均为非霍奇金淋巴瘤。B细胞来源11例，T细胞来源2例。随诊期间(5～112个月)7例无瘤生存，3例死于肿瘤，1例死于并发症，2例死于其他疾病，1例失随。大范围的手术切除对患者的生存无明显提高。结论 外科手术对甲状腺淋巴瘤的作用有限，对肿瘤局限在甲状腺内的患者，行手术切除结合放疗和(或)化疗对生存有益，否则仅起到组织诊断的作用。
The role of surgery in themanagement of thyroid lymphoma
LI Zhengjiang, TANG Pingzhang, HUANG Yirong, et al. Department of Headand Neck Surgery, Cancer Hospital, Peking Union Medical College, Chinese Academy ofMedical Science, Beijing 100021
【Abstract】 Objective To evaluate the roleof surgery in the management of thyroid lymphoma.Methods Aretrospective analysis was performed of 14 patients with thyroid lymphoma treated at theCancer Hospital, Peking Union Medical College, Chinese Academy Medical Science from 1964to March 1998. There were 5 males and 9 females, with a median age of 54 years (range 15～75).There were 4 cases in stage IEA, 9 in stage IIEA, 1 in stage ⅡEB. Fine needle aspirationbiopsy was performed in 1 case, excision biopsy in 4, thyroid lobectomy in 8, and totalthyroidectiomy in 1. Radiotherapy was used alone in 4 patients, chemotherapy alone in 2,radiotherapy combined with chemotherapy in 7, no postoperative treatment in 1.Results Allbut 1 patients were histopathologically diagnosed as non-Hodgkin′s lymphoma. It was of Bcell origin in 11 cases, T cell origin in 2. Seven patients were alive without evidence ofrecurrent disease at follow-up, ranging from 5 to 112 months. Three patients died oflymphoma, 1 died of treatment complication, 2 died of other diseases, and 1 lost fromfollow-up. The major surgical resection did not appreciably affect survival.Conclusion Radiotherapyor chemotherapy, alone or in combination, is the treatment of choice for thyroid lymphoma.Surgical resection combined with radiotherapy or chemotherapy may be beneficial tosurvival in patients with intrathyroid lymphoma. It is otherwise limited to make a tissuediagnosis.
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