肠道T细胞淋巴瘤临床病理及影像学特点(附11例报告)

Features of clinical pathology and imaging of primary intestinal T-cell lymphoma(A report of 11 cases)

目的探讨原发性肠道T细胞淋巴瘤的临床特点。方法对作者1999年1月～2009年1月间收治的11例原发性肠道T细胞淋巴瘤的病史资料进行回顾性分析。结果 11例原发性肠道T细胞淋巴瘤患者中,空肠、回肠和结肠均可被累及,以空、回肠多见。临床表现以腹痛、腹泻、发热、消瘦为主,部分患者并发肠穿孔、肠梗阻、消化道出血。内镜下3例患者表现为溃疡病灶,术中见溃疡6例,肿块4例。4例曾被误诊为炎症性肠病。免疫表型为LCA+、CD45RO+、CD3+、CD30-。所有患者均接受手术治疗,部分结合术后化疗。3例患者于术后3个月内死亡。结论原发性肠道T细胞淋巴瘤常表现为非特异性症状,临床常被误诊为炎症性肠病(IBD)。内镜活检和手术标本的病理学检查是目前确诊原发性肠道T细胞淋巴瘤的主要依据。

Objective To investigate the clinical characteristics of primary intestinal T-cell lymphoma. Methods A data of 11 cases of primary intestinal T-cell lymphoma admitted in Sun Yat- sen Memorial Hospital from January 1999 to January 2009 were collected and analyzed retrospectively. Results The age of the patients enrolled in this study ranged from 31 to 75 years,8 of them were male and 3 female. In the patients with primary intestinal T-cell lymphoma,The tumors involved in jejunum, ileum and colon, but most of them were located in jejunum and ileum. The chnical manifestations were mainly abdominal pain, diarrhea, fever, and weight loss. Some patients developed intestinal perforation, obstruction or gastrointestinal bleeding. The tumors were presented as multiple ulcers endoscopically in 3 patients, ulceration in 6 and a mass in 4. Four patients were misdiagnosed as inflammatory bowel disease （IBD）.The immunophenotype of the tumor ceils were LCA＋, CD45RO＋, CD3＋, CD30-.All patients were received surgical operation, some of them received combined surgery with chemotherapy. Three ]patients died in 3 months after operation. Conclusions The patients with primary intestinal T-cell lymphoma usually present non-specific syndromes, resulting in misdiagnosis as inflammatory bowel disease （IBD）. The definite diagnosis depends on the pathological examination of endoscopic biopsy specimens or surgical specimens.