原发性大肠恶性淋巴瘤26例临床病理分析

Clinicopthological analysis of primary malignant lymphoma of large intestine in 26 cases

目的:分析大肠恶性淋巴瘤临床病理特征及其预后的有关因素。方法:将我院收治的大肠淋巴瘤患者的病史资料及组织切片进行分析。结果:1036例大肠恶性肿瘤中26例为恶性淋巴瘤占2.51%,男女之比为2.1:1,平均病程4.8个月,临床表现以腹部肿块、腹痛、体质量下降以及血便、腹胀为主要特点,本病少见,临床易误诊为癌。肿瘤位于回盲部15例,升结肠5例,横结肠2例,降结肠3例,直肠1例。病理类型属非霍奇金淋巴瘤22例,霍奇金病4例。治疗采用根治性手术切除为主的综合治疗。结论:诊断应综合临床表现、影像学及内窥镜检查结果,确诊依靠病理检验,治疗采用根治性手术切除为主的综合治疗,预后较好。

Objective：To review the clinicopathological features and the prognosis related factors of primary malignant lymphoma of large intestine.Methods：Twenty-one patients with primary malignant lymphoma of large intestine were treated in our hospital from 1976 to 2009 and their medical data and surgical specimens were reviewed.Results：Only 26 cases among 1036 cases of primary malignant tumors of large intestine were proved pathologically to be primary malignant lymphoma with the incidence as low as 2.51%.Male：female was 2.1：1.The clinical symptoms and signs of this type of malignancy were similar to those of carcinoma of large intestine.Among 26 cases,the lesions of 15 cases located in ileocecal region,5 in ascending colon,2 in transverse colon,3 in descending colon,and 1 in rectum.Pathological types：22 cases were non-Hodgkin＇s lymphoma,and 4 cases were Hodgkin＇s lymphoma.Radical surgical resection was the major choice for this type of malignancy.Conclusion：The final diagnosis of primary malignant lymphoma of large intestine could be made only by pathological examination.The radical surgical operation remains to be the major choice of treatment with better prognosis.