原发性胃肠道恶性淋巴瘤64例临床分析

Diagnosis and treatment of the primary malignant lymphoma in gastrointestinal tract:A report of 64 cases

目的:探讨原发性胃肠道恶性淋巴瘤的发病、诊断、治疗。方法:对64例经病理证实的原发性胃肠道恶性淋巴瘤的临床资料并结合相关文献进行回顾性分析。结果:本病占同期胃肠恶性肿瘤的2.7%,64例患者平均年龄39.5岁。好发部位顺序为回盲部及回肠(54.69%)、胃(21.875%)、结肠(14.06%)、直肠(9.375%)。主要临床表现是腹胀、腹痛、腹部包块、腹泻、血便。病理类型本组64例中,非何杰金氏淋巴瘤58例,其中 B 细胞型52例,T 细胞型6例;何杰金氏淋巴瘤6例。本病早期极易误诊为其它消化道疾病,误诊率为67%。结论:原发性胃肠道恶性淋巴瘤的诊断应综合临床表现、影像学及内镜检查结果,以提高诊断符合率。治疗以手术加化疗、放疗疗效最佳。

Objective;To investigate the pathogenic characteristics and the effective methods of diagnosis and treatment for primary malignant lymphoma of gastrointestinal tract.Methods:The clinical data of 64 patients with primary malignant lymphoma of gastrointestinal tract were retrospectively analyzed.Results;This disease accoun- ted for 2.7% of the malignant tumors of gastrointestinal tract during the corresponding period.The average age of the patients was 39.5 years.This disease was mainly situated in the ileocecal region and ileum (54.69%),fol- lowed by stomach (21.875%),colon (14.06%) and rectum (9.375%).The clinical manifestations were charac- terized by abdominal mass,abdominal pain,abdominal distension,bloody stool and diarrhoea etc.The non- Hodgkins lymphoma constituted the majority of pathological type,while the diffuse B-lymphocyte lymphoma was the main histological type.However,this disease was easily misdiagnosed,and the misdiagnosis rate was 67% in this investigation.Conclusions;The diagnosis must be based on the results of clinical manifestations,tomography, endoscopy.In order to improve the long-term results,it was essential to treat the patients with radical resection followed by chemotherapy and/or radiotherapy.