原发性肠道淋巴瘤41例诊断情况分析  

Diagnosis analysis of 41 cases of primary intestinal lymphoma

作　　者：吴琪芳[1] 许建明[1] 胡静[1] 曹立宇[2] 吴兴旺[3] 张超[4] 

机构地区：[1]安徽医科大学第一附属医院消化科,合肥230022 [2]安徽医科大学第一附属医院病理科,合肥230022 [3]安徽医科大学第一附属医院放射科,合肥230022 [4]安徽医科大学第一附属医院普外科,合肥230022

出　　处：《安徽医学》2012年第6期668-670,共3页Anhui Medical Journal

摘　　要：目的原发性肠道淋巴瘤术前诊断困难,误诊、漏诊率较高。本研究拟以手术病理为金标准,探讨其术前误诊、漏诊原因,总结经验教训,以提高临床诊疗水平。方法收集近10年来接受手术治疗的41例原发性肠道淋巴瘤患者的病历资料,分析其诊断情况、临床表现、内镜及影像学检查资料。结果原发性肠道淋巴瘤患者的临床表现以腹痛(33/41,80.5%)、腹部包块(19/41,46.3%)常见,并发症中以消化道出血多见(7/20,35.0%)。术前拟诊为原发性肠道淋巴瘤者6例(14.6%),未定性诊断的25例(63.4%)患者主要系内镜病理未证实或影像学检查征象无特异性,误诊/漏诊的9例(22.0%)患者术前分别被诊断为单纯性肠梗阻、肠穿孔、肠套叠、结肠癌、阑尾病变、炎症性肠病、肠结核。结论加强对原发性肠道淋巴瘤的认识,细致的病史采集和体格检查,选择合适的辅助检查,加强与内镜、影像、病理科医师的交流协作,将有助于降低误诊、漏诊率,提高临床诊断水平。Objective The preoperative diagnosis of primary intestinal lymphoma was difficult, and the misdiagnosis rate was high. Our aim was to investigate the reasons of misdiagnosis, using surgical pathology as the golden standard. Methods Clinical data of 41 cases with primary intestinal lymphoma who accepted surgical therapy over the past decade were collected, and the diagnosis, clinical manifestation, endoscopy and imaging signs were analyzed. Results Patients with primary intestinal lymphoma presented mainly with abdominal mass, abdomi- nal pain（33/41,80.5%）, abdominal masses（ 19/41,46.3% ）, the most common complication was blood stoo1（7/20,35.0%）. Six cases（14.6%） were diagnosed as primary intestinal lymphoma; 25 cases （63.4%） didn＇t acquire qualitative diagnosis, whose pathological results of endoscopy were not confirmed or the imaging signs were not specific; 9 cases （22.0%）were misdiagnosed as simple intestinal obstruction, intestinal perforation, intussusception, colon cancer, appendiceal lesions, inflammatory bowel disease, and intestinal tuberculosis. Conclusion Strengthening the i- dentification of primary intestinal lymphoma, detailed history investigation and physical examination, choosing suitable assistant examination, increasing exchange and cooperation with endoscopy, imaging, pathological physicians will help us to reduce the misdiagnosis rate, and im- prove the level of clinical diagnosis.

关 键 词：原发性肠道淋巴瘤 误诊 手术 

分 类 号：R735.3[医药卫生—肿瘤]