CT联合内镜检查对胃肠道恶性淋巴瘤的诊断价值

Value of spiral CT and endoscopic in the diagnosis of primary gastrointestinal malignant lymphoma

目的探讨原发性恶性淋巴瘤患者(PGIML)的临床特点及CT、内镜、超声内镜表现。方法回顾性总结分析45例PGIML的临床资料,所有病例均经内镜活检或手术后病理组织学所证实。结果45例PGIML主要临床表现为腹痛,胃为最好发部位,占71.1%(32/45),尤以胃窦常见。内镜活检确诊率55.6%(20/36),超声内镜确诊率达100%(4/4),CT确诊率66.7%(20/30)。其中B细胞性淋巴瘤是最常见的病理类型,占93.3%(42/45)。结论PGIML以腹痛为主要临床表现,胃的发生率最高,主要病理类型为B细胞性。内镜活检加CT检查可提高术前确诊率。超声内镜检查对胃恶性淋巴瘤诊断有重要意义。

[Objective] To study the clinical, endoscopic and CT of primary gastrointestinal malignant lymphoma （PGIML）. [Methods] The clinical, endoscopic and CT data in 45 cases of primary gastrointestinal malignant lymphoma were reviewed retrospectively. All cases were confirmed with histological specimen obtained from endoscopic biopsies or surgery. [Results] The main clinical feasures of PGIML patients was abdominal pain.The incidence of PGIML was highest in stomach, seen in 32 of 45 patients （71.1%）. The positive rate of endoscopic biopsy, EUS and CT for the diagnosis of PGIML was 55.6.1% （20/36）, 100% and 66.7% （20/30） respectively. B-cell lymphoma was the predominant type, seen in 42 of 45 cases （93.3%）. {Conclusions] Abdominal pain was the most common symptom and the stomach was the most location in PGIML Endoscopy and CT examination ean improve the aeeuraey of diagnosis of PGIML. Endoscopie ultrasonography was meaningful for the diagnosis of PGML.