原发性胃肠恶性淋巴瘤误诊分析  

Clinical misdignosis analysis of primary gastrointestinal malignant lymphoma

作　　者：毛盛勋[1] 杨刚[1] 

机构地区：[1]南昌大学第二附属医院普外科,江西南昌330000

出　　处：《中国医药导报》2008年第3期110-111,共2页China Medical Herald

摘　　要：目的:探讨原发性胃肠道恶性淋巴瘤的误诊原因。方法:对我科2000年5月～2006年7月收治的22例原发性胃肠道恶性淋巴瘤的临床资料进行回顾性分析。结果:22例均行胃肠镜及病理检查。其中,胃淋巴瘤15例:仅1例确诊,术前10例误诊为胃低分化腺癌,3例误诊为胃未分化腺癌,1例误诊为胃溃疡。肠淋巴瘤7例:也仅1例确诊,2例误诊为肠结核,4例误诊为腺癌。22例均行手术治疗,术后1例出现切口感染,1例出现肺部感染,并发症和其他手术相比无差异。经治疗后均全部顺利出院。术后给予化疗,无一例死亡。结论:原发性胃肠道恶性淋巴瘤误诊率高,手术和术后病理免疫组化检查是主要的确诊方法,手术联合化疗具有较好的疗效。Objective：To evaluate the cause of misdiagnosis primary gastrointestinal malignant lymphoma （PGIML）. Methods：A total of 22 patients with PGIML underwent operation in our department form May 2000 to July 2006 were reviewed retrospectively. Results： All of those patients had endoscopy and biopsy＇ Amony them 15 cases were gastric malignant lymphoma.Only one case was confirmed the diagnosis of PGIML before operation. 10 cases were misdiagnosed as poorly differentiated adenocarcionoma. 3 cases were misdiagnosed as undifferential adenocarcinoma. 1 case was diagnosed as gastric ulcer.There were 7 cases intestinal lymphoma.Only one case was confirmed the diagnosis of PGIML before operation also. 2 cases were misdiagnosed as tuberculosis of intestine. 4 cases were misdiagnosed as adenocarcinoma.All those 22 cases patient had operation. 1 case had wound infection.All those patients were discharged successfully after surgery and chemotherapy, no case died. Compared to other operation, there was no difference in operative the complications. Conclusion：The misdiagnosed rate of PGIML is at a very high level before operation.Surgery pathology and immunohistochemistry after surgery are important methods to confirm the diagnosins of PGIML. Surger following combine with chemotherapy has a curative effect on PGIML.

关 键 词：恶性淋巴瘤 外科手术 诊断 

分 类 号：R730.264[医药卫生—肿瘤]