肠道非霍奇金淋巴瘤临床病理学观察

Clinicopathologic Analysis of Intestinal Primary Lymphoma

目的：进一步认识肠道原发性NHL的临床病理学特征。方法：收集肠道淋巴瘤20例，应用多组织石蜡切片技术，免疫组化S-P方法标记观察。结果：20例中男16例，女4例，年龄12～78岁，平均53岁。临床表现以腹胀、下腹疼痛，腹内可触及包块为主要症状。发生部位回盲部8例、小肠7例、结肠4例、直肠1例。形态表现MALT型淋巴瘤19例，其中弥漫性大B细胞淋巴瘤伴MALT型淋巴瘤表现6例；肠病型间变性T细胞淋巴瘤1例。结论：肠道淋巴瘤以MALT型最多见，临床上很难与肠癌鉴别，早期诊断依赖肠镜活检，预后与规范化治疗有关。

Objective： To further understand the clinical and pathological features of intestinal primary lymphoma. Methods： 20 cases of intestinal primary lymphoma were obtained and their clinicopathologic features were analyzed by paraffin- embedded section observation and immunohistochemical technique. Results： 16 male and 4 female patients were included （ranging from 12 to 78 years old, mean age = 53 years）. Clinical symptoms showed abdominal pain, abdominal distension and mass of abdominal eminence. The analysis of blood was normal. 8 tumors located in ileocecal junction, 7 in small intestine, 4 in colon and 1 in rectum. There were 19 cases of MALT, including 6 cases of diffuse large B cell lymphoma with MALT, and 1 case of anaplastic large cell lymphoma, according to morphologic pathology. Conclusion： MALT is the most common lymphoma in intestinal tract. It is difficult to be identified from carcinoma by clinical symptoms and image examinations in diagnosis. The early diagnosis of MALT depends on endoscopic biopsy, which is always restricted by the location of biopsy, and sometimes more than one biopsy is required. The prognosis of MALT is relevant to the regulated chemotherapy.