Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya30876Editorial articleПередовая статьяPrimary mediastinal (thymic) large B-cell lymphoma: review of the literature and original dataПервичная медиастинальная (тимическая) В-крупноклеточная лимфома: обзор литературы и собственные данныеKichiginaMariya Yur'evnaКичигинаМария Юрьевна

врач, отд-ние химиотерапии гемобластозов РОНЦ им. Н. Н. Блохина РАМН, тел.: 8-495-324-28-54; Российский онкологический научный центр им. Н. Н. Блохина PAMН

kmy_ronc@mail.ruTumyanGayane SergeevnaТумянГаяне Сергеевна

д-р мед. наук, вед. науч. сотр., отд-ние химиотерапии гемобластозов РОНЦ им. Н. Н. Блохина, тел.: 8-495-324-98-29; Российский онкологический научный центр им. Н. Н. Блохина PAMН

KovriginaAlla MikhaylovnaКовригинаАлла Михайловна

д-р биол. наук, вед. науч. сотр., отд. патологической анатомии опухолей человека РОНЦ им. Н. Н. Блохина РАМН, тел.: 8-495-324-61-02; Российский онкологический научный центр им. Н. Н. Блохина PAMН

TrofimovaOksana PetrovnaТрофимоваОксана Петровна

канд. мед. наук, ст. науч. сотр., отд. радиационной онкологии, радиологическое отд-ние РОНЦ им Н. Н. Блохина РАМН, тел.: 8-495-324-10-70; Российский онкологический научный центр им. Н. Н. Блохина PAMН

LarionovaVera BorisovnaЛарионоваВера Борисовна

д-р мед. наук, вед. науч. сотр., отд-ние химиотерапии гемобластозов РОНЦ им. Н. Н. Блохина РАМН , тел.: 8-495-324-92-09; Российский онкологический научный центр им. Н. Н. Блохина PAMН

ChekanAnna Anatol'evnaЧеканАнна Анатольевна

аспирант, отд-ние химиотерапии гемобластозов РОНЦ им. Н. Н. Блохина; Российский онкологический научный центр им. Н. Н. Блохина PAMН

BykovDmitriy AleksandrovichБыковДмитрий Александрович

асс. каф. онкологии Первого МГМУ им И. М. Сеченова; Российский онкологический научный центр им. Н. Н. Блохина PAMН

OsmanovD ShОсмановД Ш

д-р мед. наук, зав. отд-нием химиотерапии гемобластозов РОНЦ им. Н. Н. Блохина , тел.: 8-495-324-28-04; Российский онкологический научный центр им. Н. Н. Блохина PAMН

KichiginaM Yu

N.N. Blokhin Cancer Research Center, Moscow

TumyanG S

N.N. Blokhin Cancer Research Center, Moscow

KovriginaA M

N.N. Blokhin Cancer Research Center, Moscow

TrofimovaO P

N.N. Blokhin Cancer Research Center, Moscow

LarionovaV B

N.N. Blokhin Cancer Research Center, Moscow

ChekanA A

N.N. Blokhin Cancer Research Center, Moscow

BykovD A

N.N. Blokhin Cancer Research Center, Moscow

OsmanovD Sh

N.N. Blokhin Cancer Research Center, Moscow

Российский онкологический научный центр им. Н. Н. Блохина PAMНN.N. Blokhin Cancer Research Center, Moscow15072011837NO7 (2011)ТОМ 83, №7 (2011)384610042020Copyright ©; 2011, Consilium MedicumCopyright ©; 2011, ООО "Консилиум Медикум"2011Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/30876

Aim. To study morphoimmunological and clinical features of primary mediastinal large B-cell lymphoma (PMLBCL). Material and methods. We analysed the results of biopsy material study and treatment of 86 PMLBCL patients, effects of different factors on the disease prognosis, efficacy of some therapeutic programs and overall therapeutic efficacy. Results. PMLBCL manifests mainly with massive lesions of anterior upper mediastinum with involvement of adjacent organs and tissues, absence of bone marrow involvement, frequent affection of CNS. Many primary patients have resistance to treatment, sensitive patients have no late recurrences. Conclusion. PMLBCL is an independent extranodal variant of non-Hodgkin's lymphoma with special clinical and morphoimmunological characteristics. Criteria are proposed for differential diagnosis of different variants of PMLBCL. New approaches to PMLBSL patients' management are outlined.

Цель исследования. Изучение морфоиммунологии опухолевого субстрата ПМВКЛ, особенностей клинического течения и оценка результатов современных программ лечения. Материалы и методы. Работа проведена на биопсийном и клиническом материале 86 пациентов с ПМВКЛ. Результаты. Основными клиническими проявлениями ПМВКЛ являются массивное поражение переднего верхнего средостения с вовлечением прилежащих органов и тканей, характерны отсутствие поражения костного мозга и большой процент вовлечения ЦНС. В общей популяции первичных пациентов с ПМВКЛ выявляется значительная популяция резистентных больных, в группе чувствительных к лечению поздних рецидивов нет. Заключение. ПМВКЛ является самостоятельным экстранодальным вариантом неходжкинской лимфомы с особенными клиническими и морфоиммунологическими характеристиками. На основании полученных результатов предложены критерии дифференциальной диагностики различных вариантов крупноклеточных лимфом средостения. На основе анализа современных программ лечения предложены новые тактические подходы к ведению данного контингента больных.

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