胃原发性恶性淋巴瘤22例临床分析

Clinical Analysis of Primary Malignant Gastric Lymphoma (A Report of 22 cases)

目的探讨胃原发性恶性淋巴瘤临床及内镜表现。方法分析总结22例患者临床、胃镜及病理。结果22例患者临床表现无特异性,上腹痛最常见(22/22),其次为上消化道出血(16/22)、反酸嗳气(6/ 22)等。胃镜表现:病变发生2个以上部位多见(10/22),其次为胃体(6/22)、胃窦(3/22)等;病变直径多大于2 cm(占17/22);病变形态以溃疡型多见(11/22),其次为弥漫浸润型(7/22);胃镜活捡加免疫组化确诊率为63.63%(14/22);Hp阳性检出率86.36%(19/22)。结论胃原发性恶性淋巴瘤临床表现无特异性:其镜下形态多种多样,其中累及2个以上部位者多见,病变范围较大。胃镜活检加免疫组化病理检查是诊断本病的重要手段,Hp感染与胃原发性恶性淋巴瘤的发生具有相关性。

Objective To investigate the clinical and endoscopic features of patients with primary malignant gastric lymphoma. Methods Clinical, gastroscopic features and pathological results of 22 patients were analyzed and summarized. Results There was no specific clinical features. Epigastric pain was the most frequent symptom (22/22), upper alimentary tract bleeding (16/22), acid regurgitation and belching (6/33) were also noticed. Gastroscopic features: tumors involving two parts of stomach were found in 10 patients (10/22), gastic body (6/22) and gastric antrum (3/22), respectively. Tumor size was larger than 2cm in 17 pativents (17/ 22); The most frequent type was ulcer-type tumor, and the second one was diffused infiltrating-type. The diagnosis rate of gastroscopic biopsy and immunohistochemistry was 63.63% (14/22); The detection rate of H.pylori was 86.36%. Conclusions Primary malignant gastric lymphoma has no specific clinical features. However, it has various appearances under gastroscopy. In most patients, the tumor involves more than 2 parts of the stomach. Gastroscopic biopsy and immunohistochemistry is an important method to diagnose this disease. H.pylori infection is related to the oncogenesis of Primary Malignant Gastric Lymphoma.