胃肠道粘膜相关淋巴组织淋巴瘤27例的临床与病理

Clinical and Pathological Features in Patients with Gastrointestinal Mucosa-associated Lymphoid Tissue Lymphoma: Analysis of 27 Cases

分析27例原发性胃肠道粘膜相关淋巴组织(MALT)淋巴瘤的临床和病理情况,旨在提高对本病的认识。方法:收集27例胃肠道MALT淋巴瘤,其中胃16例,肠11例。对其临床、病理情况和治疗方法进行分析。结果:16例胃淋巴瘤中,病变位于胃窦部9例(56％);2个病灶者1例。11例肠淋巴瘤中,病变位于回盲部5例(45.5％);多发病灶4例,其中1例累及全小肠。病灶直径≥5cm者16例。27例病理检查病变局限于粘膜下层2例,浸润至肌层8例,全层12例,浆膜外组织5例。存在区域淋巴结转移者9例。结论:本病误诊率较高,待确诊时病变多属中晚期。治疗应行根治性手术切除。术后辅以化疗或放疗可提高治疗效果。

Aims: Twenty-seven patients with gastrointestinal mucosa-associated lymphoid tissue-(MALT) lymphoma were studied. Methods: The features of clinic, pathology and treatment of 27 patients with gastrointestinal MALT lymphoma were analysed. Results: Among 16 cases with gastric lymphoma, 9 cases originated in the antrum. and among 11 cases with intestinal lymphoma, 5 cases originated in the region of the ileocecum. In 4 of 11 cases, multiple tumors were found, and 1 of them multiple lesions involved all small intestine. The gross finding of tumor was nodular in 16 cases, ulcerative in 9 cases and infiltrative in 3 cases. The tumor size was larger than 5 cm in 16 cases. In pathological study the tumor involved the submucosa in 2 cases, the muscularis propria in 8 cases, the serosa in 11 cases and adjacent organs in 5 cases. The metastases of local lymph nodes were found in 9 cases. In immunohistochemistry analysis all were B-cell lymphoma. Conclusions: Most of patients with gastrointestinal MALT lymphoma were in late stage when accurate diagnosis was made. To improve the prognosis, radical surgery for gastrointestinal MALT lymphoma should be undertaken and combined with radio-and chemotherapy after operation.