小肠脂肪瘤14例临床病理分析  

Small intestinal lipoma: a clinicopathologic analysis of 14 cases

作　　者：朱燃 罗玉凤[1] 吴焕文[1] 姜英[1] ZHU Ran;LUO Yu-feng;WU Huan-wen;JIANG Ying(Department of Pathology, Peking Union Medical College Hospital, Beijing 100730, China;Department of Pathology, Changping Hospital of Integrated Chinese and Western Medicine, Beijing 102208, China)

机构地区：[1]北京协和医院病理科,北京100730 [2]北京市昌平区中西医结合医院

出　　处：《诊断病理学杂志》2018年第6期410-413,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的分析小肠脂肪瘤的临床病理学特征、诊断思路及预后。方法收集北京协和医院2010—2016年间病理诊断为小肠脂肪瘤的全部病例,进行临床病理分析及文献回顾。结果 14例小肠脂肪瘤病例中,男女比例1∶1.33,平均年龄51岁。9例发生在回肠,4例发生在十二指肠,1例发生在空肠。肿瘤直径0.5~7.5 cm。9例出现腹痛,7例出现腹部肿块并发生肠套叠。单发小肠脂肪瘤者12例,多发小肠脂肪瘤者2例;其中1例多发脂肪瘤伴部分小肠黏膜呈腺瘤样增生,1例单发脂肪瘤伴部分小肠黏膜呈错构瘤息肉样增生。十二指肠脂肪瘤均为单发病例。随访11~92个月,13例健在,1例因结肠腺癌术后复发而死亡。结论小肠脂肪瘤患者的临床表现与病变肠段的解剖部位和肿瘤的大小密切相关,依靠病理确诊,肿瘤的长期刺激可能会引起局部肠黏膜腺体呈腺瘤样或错构瘤样增生。Objective To study the clinicopathologic feature,diagnostic strategy and prognostic significance of small intestinal lipoma. Methods All patients previously diagnosed as small intestinal lipoma during the period from 2010 to 2016 were evaluated about clinical data and histopathology,the patients were followed up and the relevant literatures were reviewed. Results In this series,there were 14 cases of small intestinal lipoma and the mean age was 51 years with a male/female ratio of 1∶ 1. 33. The ileum was involved initially in 9 patients,the duodenum in 4 and the jejunum in 1. The major axis of the tumor ranged from 0. 5-7. 5 cm. It presented with intussusception when the major axis of the tumor was≥2. 5 cm. Twelve cases were diagnosed as solitary nodule,and 2 cases were multiple nodules. Microscopically,nine cases were diagnosed as pure intestinal lipoma,2 cases were intestinal lipoma with massive inflammatory cells infiltration,1 case was multiple small intestinal lipoma with adenomatous hyperplasia of intestinal mucosa,1 case was single small intestinal lipoma with hamartoma hyperplasia of intestinal mucosa and 1 case was angiolipoma. Follow-up of 11-92 months showed that 13 patients were alive and 1 patient died because of postoperative vecurrence of colon cancex. Conclusion Small intestinal lipoma is very rare and has a good prognosis. The clinical manifestation are related to the size of the tumor and anatomic locations of small intestinal lipoma. The long-term stimulation of small intestinal lipoma might cause the local adenomatous and hamartoma hyperplasia of the intestinal mucosa.

关 键 词：小肠脂肪瘤 肠套叠 临床病理特征 病理诊断 

分 类 号：R735.32[医药卫生—肿瘤]