原发性大肠恶性淋巴瘤的内镜诊断  

Endoscopic diagnosis of primary colorectal malignant lymphoma

作　　者：李明[1] 张琳[1] 甘少光[1] 严衍伟[1] 

机构地区：[1]肇庆市第一人民医院消化科,广东肇庆526021

出　　处：《中国基层医药》2005年第5期535-536,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨大肠原发性恶性淋巴瘤(PCML)的临床表现、内镜特点,提高诊断水平。方法回顾性分析经病理证实的18例PCML的临床和内镜资料。结果18例患者主要症状为腹痛、体重下降、发热、腹块、血便和大便习惯改变。内镜下为结节型9例(50.0%),溃疡型5例(27.8%),浸润型4例(22.2%)。肿瘤起源于B淋巴细胞16例(88.9%),T淋巴细胞2例(11.1%)。内镜活检病理诊断PCML10例,手术后病理诊断8例。结论临床表现无特异性,内镜下表现与大肠癌或克隆病难以区分。Objective To study the clinical manifestations and endoscopic features of primary colorectal malignant lymphoma(PCML),and to improve its diagnostic efficiency.Methods The clinical,pathologic and endoscopic data of 18 cases of primary colorectal mlignant lymphoma were retrospectively reviewed.Results In these cases,the commom presentations included abdominal pain,loss of weight,fever,abdominal mass,blood in stools,and chang in bowel movements.These patients were all examined by endoscopy with protruding(n=9,50.0%),ulcerative(n=5,27.8%) and infiltrative(n=4,22.2%).The tumor might originate from the following organisms:B Cell(n=16,88.9%),T cell(n=2,11.1%).10 cases of PCML were diagnosed by endoscopic biopsg pathology,8 cases were diagnosed by post-operative pathology.Conclusion The primary colorectal malignant lymphoma has a rather low incidence,and has no specific clinical manifestation.It's hard to differentiate large intestinal cancer from Crohn's disease through the manifestation in endoscopy.Muti-focus sub-mucosa biapsy combined with immunohistochemistry were helpful for diagnosis.

关 键 词：原发性大肠恶性淋巴瘤 内镜诊断 大肠原发性恶性淋巴瘤 术后病理诊断 临床表现 回顾性分析 B淋巴细胞 T淋巴细胞 内镜下表现 内镜特点 诊断水平 PCML 病理证实 主要症状 体重下降 大便习惯 肿瘤起源 内镜活检 结节型 溃疡型 

分 类 号：R735.34[医药卫生—肿瘤] R735.204[医药卫生—临床医学]