表现为急腹症的肠道T细胞淋巴瘤3例临床分析  

Clinical analysis of primary intestinal T type-cell lymphoma with acute abdomen: study of 3 cases

作　　者：杨俊文[1] 姚时春[1] 马升高[1] 吴明[1] 

机构地区：[1]温州医学院附属第一医院消化内科,浙江温州325000

出　　处：《中国现代医学杂志》2008年第13期1894-1896,1899,共4页China Journal of Modern Medicine

摘　　要：目的了解原发性肠道T细胞淋巴瘤的临床特点。方法对该院2000年1月～2006年12月3例原发性肠道T细胞淋巴瘤的病史资料进行回顾性分析。结果该组原发性肠道T细胞淋巴瘤患者年龄21～73岁,均为男性,病变多位于回肠,可有结肠累及。临床表现以腹痛、肠穿孔、肠梗阻、消化道大出血为主,无患者伴有乳糜泻。内镜下1例患者表现为结肠溃疡病灶,术中见溃疡2例(回肠及结肠各1例),回肠肿块1例。1例患者经内镜活检病理检查确诊,2例由术后病理检查确诊,1例曾被误诊为Crohn氏病。淋巴瘤细胞的免疫表型为T细胞抗原CD45RO+、CD3+。3例患者均接受手术治疗。结论以急腹症为首发症状、不伴有乳糜泻、不易与炎症性肠病鉴别是本组原发性肠道T细胞淋巴瘤的特点之一。内镜活检和手术标本的病理学检查是目前确诊原发性肠道T细胞淋巴瘤的主要依据。[Objective] To analyze the clinical characteristics of primary intestinal T-cell lymphoma. [Methods] All three cases of primary intestinal T-cell lymphoma admitted in our hospital from January of 2000 to December of 2006 were collected and analyzed retrospectively. [Results] The age of the patients who all were males enrolled in this study ranged from 21 to 72 years. The lymphoma mainly occurred in the ileum, and might occur in the colon. The main clinical manifestations were acute abdominal pain, complicated by intestinal perforation, obstruction or gastrointestinal hemorrhage. No patient was accompanied by celiac disease. The tumor was presented as multiple ulcers in 2 patients or a mass in 1 patient during the endoscopy or operation. One patient was diagnosed by preoperative pathological examination of the endoscopic biopsy specimens,and 2 by surgical specimens. One patient has been mlsdiagnosed as Crohn disease. The imunophenotype of the tumor cells were T-cell common antigen CD45RO＋, CDs＋. All three patients received surgical operation. [Condusion] In this study, patients with primary intestinal T-cell lymphoma, which are difficult to be differentiated from IBD endoscopically, are not accompanied with celiac disease. The clinical manifestations are acute abdomen firstly. The definite diagnosis depends on the pathological examination of endoscopic biopsy specimens or surgical specimens.

关 键 词：肠肿瘤 肠道T细胞淋巴瘤 急腹症 

分 类 号：R735.3[医药卫生—肿瘤]