原发性小肠淋巴瘤30例诊治分析

Diagnosis and treatment for primary small intestine lymphoma of 30 cases

目的:分析总结原发性小肠淋巴瘤,提高诊断及处理水平。方法:回顾性分析我院1991～2004年间30例原发性小肠淋巴瘤的临床病理特点。结果:隐性失血、脐周隐痛、腹部肿物、隐匿消瘦是原发性小肠淋巴瘤的最常见表现。术前确诊为小肠肿瘤43.3%。30例小肠淋巴瘤中66.7%(20/30)行小肠肿瘤根治术,16.7%(5/30)行减瘤荷手术,16.7%(5/30)行姑息手术。术后病理结果均为非霍奇金淋巴瘤,其中B细胞型27例,T细胞型3例,18例发生淋巴转移。术后1年总生存率为66.7%。结论:原发性小肠淋巴瘤是较少见消化道肿瘤,多种检查方法合理应用可提高术前确诊率、手术应行根治性切除术。

Objective： To analyze and summarize the clinical and pathological features for primary smah intestine lymphoma. Methods： 30 cases with primary small intestine lymphoma from 1991 to 2004 were studied retrospectively. All patients were identified by postoperative histopathological examination. Results： The main clinical features of these patients consisted of occult bleeding in digestive tract, mild abdominal pain, abdominal mass and gradual losing of body weight. In all cases, 43.3% patients had the definite diagnosis of small bowel tumor preoperatively. The 30 cases were respectively undergone curative operation （66.7%,20/30）, resection main tumor （16.7%, 5/30） or palliative operation （16.7%,5/ 30） including gut bypass, biopsy and laparotomy. The postoperative pathology of all the patients was non-Hodgkin＇s lymphoma, 27 were B cell type, 3 were T cell type. There were 18 cases with regional node metastases by pathologic examination. Overall 1-year survival rate was 66.7%. Conclusion： Primary small intestine lymphoma is rare tumors of alimentary tract. The preoperative diagnosis accuracy can be improved by appropriate application of instrument. The radical operation might be the best decision.