原发性肠道淋巴瘤的临床特点分析  

The clinical characteristics of primary intestinal lymphoma

作　　者：郑梅英[1,2,3] 王承党[1,2] 

机构地区：[1]福建医科大学消化系疾病研究室 [2]福建医科大学附属第一医院消化内科,福建福州350005 [3]福建省石狮市医院消化内科

出　　处：《胃肠病学和肝病学杂志》2015年第5期582-585,共4页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析原发性肠道淋巴瘤(primary intestinal lymphoma,PIL)的临床特点。方法回顾性分析39例确诊的PIL住院患者的临床表现、病变部位、病理类型、内镜表现、影像学特点、诊断和治疗情况等。结果 39例PIL患者中,B细胞性淋巴瘤33例(84.6%)、T细胞性淋巴瘤6例(15.4%);小肠病灶24例(61.5%)、结肠病灶11例(28.2%)、其他4例(10.3%),均为非霍奇金淋巴瘤(NHL);主要临床表现为腹痛27例(69.2%)、贫血21例(53.8%)、排便异常18例(46.2%)等。18例接受肠镜检查:9例(50.0%)大肠或回肠末端肠腔肿物、7例(38.9%)单发溃疡、4例(22.2%)息肉样增生、3例(16.7%)多发溃疡;23例接受CT或MRI检查:15例(65.2%)局限性肠壁增厚(中位厚度2.74 cm)、13例(56.5%)腹腔软组织块影、11例(47.8%)局限性管腔狭窄、9例(39.1%)肠系膜淋巴结肿大。36例接受手术治疗并获得病理学诊断。结论 PIL多见于中老年男性,常见症状是腹痛,其次为排便异常、贫血等,肠镜、CT或MRI检查有助于PIL的诊断,手术是PIL诊断和治疗的重要手段。Objective To investigate the clinical characteristics of primary intestinal lymphoma （PIL）. Methods The clinical features, laboratory findings, endoscopic and histological manifestations were analyzed retrospectively in 39 inpatients with PIL. Results In thirty-nine PIL inpatients, 24 cases （61.5%） located in the small intestine and 11 （28.2%） located in the large intestine. The main symptoms were abdominal pain （69.2%）, amnesia （53.8%）, and bowel dysfunction （46.2%）. Among 18 cases received enteroendoscope-investigation, 9 cases （50.0%） displayed a luminal mass, 7 cases （38.9%） a single ulcer, 4 cases （22.2%） with polypoid mass, and 3 cases （ 16.7% ） with multiple ulcers in the large intestine or in the ileum. In 23 patients received CT or MRI scan, 15 cases （65.2%） had local bowel wall thickening with median thickness of 2.74 cm, 13 cases （56.5%） had local mass, 11 cases （47.8%） with local luminal narrowing, and 9 cases （39.1% ） with enlarged mesenteric lymph nodes. Of 39 patients, 36 cases were successfully treated with comprehensive surgical means. Conclusion PIL has a tendency to be found more in old man and their common symptoms are abdominal pain, amnesia and bowel dysfunction. The enteroendoscope and CT/ MRI imaging are very helpful for diagnosis. Surgical operation is an important treatment and diagnostic method.

关 键 词：原发性肠道淋巴瘤 临床表现 影像学 病理学 

分 类 号：R573.1[医药卫生—消化系统]