| Objective:There have been reports in recent years that the incidence of lymphoma in common malignant tumor in China has risen to eighth, and this growth trend has been attached great importance to. And non-hodgkin’s lymphoma is one of the fastest growing incidence of malignant tumor, among them, the T cell and NK cell lymphomas were relatively rare in our country. Extranodal NK/T-cell lymphoma can occur purely serious large nonspecific lesions of the oral mucosa. Due to the malignant lymphoma is rare, extranodal NK/T-cell lymphoma with oral mucosa lesion is more rare, and the disease performance in all areas of the oral mucosa lesions present complex diversity because of the complex environment in the mouth, and it is difficult to find the clinical features of regularity so that both at home and abroad with the characteristics of the cases reported less. The research analyzed their clinical features retrospectively and summarizes the characteristics of the disease to strengthen and deepen the knowledge and understanding of it aiming at providing some theoretic references to early diagnosis to improve the early diagnosis rate, shorten the time of diagnosis.Methods :In this research, all of 10 cases, who were definitely diagnosed extranodal NK/T-cell lymphoma with oral mucosa lesion,were obtained from the Dental clinic, E.N.T. department, hematology department and radiology department of The first hospital affiliated to the Dalian medical university, and E.N.T. department, hematology depart-ment and traditional Chinese medicine rehabilitation department of The second hospital affiliated to the Dalian medical university, during a ten-years period(2005.01-2014.12).10 cases about their clinical features were analyzed retrospectively, aimed at the onset age, sex, the first part, confirmed the time, the biochemical testing indexes, virus infections, pathological classification, clinical stage, lymph node metastasis, liver and spleen imaging examination situation, the length of the course of the disease and misdiagnosis treatment methods for statistics and analysis.Results :1) 10 cases of extranodal NK/T-cell lymphoma with oral mucosa lesion patients onset ages 35 to 82 years old, mean age:56.2;Sex ratio of 9:1; 2) the high risk for the first time: jaws in 5 cases, nasal 3 cases, gum in 1 case, pharyngeal 1 case;3) Clinical stage: period 6 cases, Ⅱ period 3 cases, Ⅳ period 1 case; 4)Pathological classification: al 10 cases of exterior non-hodgkin’s lymphoma with oral mucosa lesions derived from T cells, a diagnosis of NK/T cell lymphoma; 5) confirmed: the time from onset to confirmed time is 1 ~ 36 months, an average of 8.7 months; 6) laboratory: the laboratory examination of the disease is a lack of specificity. The liver meritorious service is abnormal 4,(4/10). A total of 9 cases of patients with renal function inspection, abnormal 4 cases(4/9). β2 serum globulin inspections on 4 cases, 2 cases of higher, 2 cases of normal. Ten patients increased blood sedimentation in 2 cases(2/10). 7) virus test: 10 patients with hepatitis b virus detection, only 1 case is positive(1/10). 8) In the diagnosis of conditions: only 1 case first option to consider for the patients with malignant lymphoma. 9) lymph node metastasis: 8 cases of the patients do the inspection, 6 cases with cervical lymph nodes or distal lymph node metastasis, 2 cases with no lymph node metastasis(6/8). 10) Imaging examination: 5 cases were examined by CT, found in 4 patients the liver, spleen and lung nodules cyst, 1 case of imaging examination did not see abnormalities. 11) Duration: 4 cases of complete disease duration, since the onset of surial was 0.5 ~ 3.5 years, the average survival period of 27.5 months. 12) treatment is given priority to with targeted chemotherapy + radiotherapy, selective use local surgery.Discussion:1) It was easy to misdiagnosis and missed diagnosis that extranodal NK/T-cell lymphoma with oral mucosa lesion patients are rare and its clinical manifestations is complex, diverse and no specificity.2) For suspected cases, it should be combined with the related auxiliary examination and a biopsy at early date; for still cannot clear diagnosis of patients should be repeated biopsy diagnosis. A biopsy should be in focal necrosis and diseased tissue border, and organizations are big enough, avoiding extruding cells to deformation, in order to improve the accuracy of biopsy. 3)The biochemical laboratory of 10 cases is lack of specificity, and immunohistochemistry has a certain significance in the diagnosis of the disease. 4) Systemic treatment with radiation and chemotherapy is given priority to the disease, oral lesions mainly for etiological treatment, but all of 10 case poor prognosis. |
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