内镜检查对原发性胃恶性淋巴瘤诊断意义

Diagnostic significance of endoscopy for primary gastric malignant lymphoma

目的:分析原发性胃恶性淋巴瘤内镜下表现特征及其病理学特点.方法:我院2004-01/2008-03住院PGML患者34例,所有患者经病理组织学证实,患者均行电子胃镜检查,并行黏膜活检病理检查,同时行免疫组织化学染色检测CD3、CD20、CD45和CK等标志物,并行病理组织HE染色,阳性即判为有Hpylori感染.结果:内镜检查34例患者,病变主要在胃体(44.1%)和胃窦(29.4%),其中累及2个及其以上病变部位占61.8%,单一部位相对较少;形态表现多为溃疡型(61.8%),主要是多发性溃疡(66.7%),弥散浸润型(26.5%),隆起糜烂型(11.8%).病理结果均为B细胞非霍奇金淋巴瘤,4例(11.8%)为大B细胞性淋巴瘤,为高度恶性胃淋巴瘤,30例(88.2%)为低度恶性淋巴瘤;幽门螺杆菌(Hpylori)感染率为占82.4%.结论:内镜检查的广泛应用及活检的充分和准确,对于PGML具有重要的确诊意义.

AIM： To investigate endoscopic features as well as pathological characteristics of primary gastric malignant lymphoma （PGML）. METHODS： A total of 34 histopathologicallyconfirmed PGML cases were analyzed from January 2004 to March 2008 in our hospital. All the patients underwent electronic gastroscopy, parallel mucosa biopsy examination and immunohistochemistry for detection of CD3, CD20, CD45 and CK. HE staining was performed and positive results were interpreted as H pylori infection. RESULTS： The tumor originated from corpus （44.1%） and antrum （29.4%）. Results showed that 61.8% of the patients involved more than 2 lesions. The 61.8% of the tumor patients appeared ulcerative, among which multiple ulcer was 66.7%, infiltrating type was 26.5%, and protrusive erosion was 11.8%. Immunohistochemistry showed B-cell lymphoma in every case, and H pylori infection was found in 82.4%.CONCLUSION： Wide use of endoscopy and correctness of biopsy make it important in the diagnosis of primary gastric malignant lymphoma.