原发性胃淋巴瘤的内镜超声检查影像特征分析

Characteristic analysis of EUS in primary gastric lymphoma

目的分析、总结原发性胃淋巴瘤(PGL)的内镜超声检查术(EUS)的影像特征,提高对PGL的诊断水平。方法分析诊断明确的PGL患者在内镜和超声影像学方面的图像,以及在治疗和随访过程中内镜和超声影像学方面动态变化,总结其在诊断和鉴别诊断方面的影像特征。结果经EUS并且病理明确诊断为PGL者24例。病变表现为溃疡型14例,结节型5例,浸润型3例和糜烂型2例。病灶位于胃窦5例,胃窦体7例,胃体8例,胃体底4例。病变浸润至黏膜下层12例,浸润至肌层7例,全层浸润5例。胃周淋巴结浸润5例。治疗后其中15例患者进行了EUS的复查和随访。结论掌握EUS的内镜和超声影像特征可以提高对PGL的诊断和鉴别诊断水平;EUS对PGL的疗效评估和复发随访具有不可替代的作用。

[ Objective ] To To investigate the characteristic manifestation of endoscopic ultrasonography （EUS） in primary gastric lymphoma （PGL）, and improve the diagnostic levels of chnicians. [Methods] The manifestations of EUS of patients with PGL identified by histology were analyzed, and the changes in the process of treatment and fol- low-up of these patients were observed, and the features of EUS were concluded in PGL. [ Results ] All the 24 pa- tients who received the EUS examination were diagnosed as PGL by histology. The tumor appeared as ulcerative type in 14 cases, nodular type in 5, infiltrative type in 3, erosive type in 2. The lesions were located at gastric antrum in 5 cases, antrum and corpus in 7, corpus in 8, fundus in 4. The lesions invaded into submucosa inl2 cases, muscular layer in 7, serous membrane in 5, gastric contiguous lymph nodes in 5.15 cases of all were followed up for EUS after treatment. [ Conclusions ] By mastering the features of EUS images of PGL, we can improve the levels of diagnosis and differential diagnosis of this disease. EUS play a crucial role in the affect assessment and recurrence follow-up of patients with primary gastric lymphoma.