消化道出血为首发表现的血液系统肿瘤的内镜表现和临床特点

Endoscopic and clinical features of blood system tumor presented initially with gastrointestinal bleeding

目的探讨以消化道出血为首发表现的血液系统肿瘤患者的临床特点及内镜下表现,总结临床经验,提高诊治水平。方法回顾性分析2009年7月～2011年4月该院收治的14例以消化道出血为首发表现的血液系统肿瘤患者临床资料。结果所有患者均以消化道出血为首发表现,10例(71.4%)有发热表现。累及食管1例,胃6例,十二指肠1例,空肠2例,回肠4例,结肠2例。10例(71.4%)为单发病变。内镜下形态表现多样,以溃疡型病变为主要表现9例,浸润型2例,肿块型2例,多发结节型1例。内镜活检确诊者5例(35.7%)。结论原发于消化道的血液系统肿瘤临床表现不典型,内镜下形态具有多型性,提高对其内镜下表现的认识,结合多取及深挖活检对提高内镜确诊率具有重要的意义。

[Objective] To explore the endoscopic and clinical characteristics of blood system tumor presented initially with gastrointestinal bleeding.[Methods] 14 cases of blood system tumor presented initially with gastrointestinal bleeding who admitted to our hospital between July 2009 and April 2011 were investigated and analyzed respectively.[Results] All patients presented with gastrointestinal bleeding initially.10 cases（71.4%） presented with fever.The lesions located in esophagus in 1case,stomach 6,duodenum 1,jejunum 2,ileum 4,colon 2.Endoscopy revealed varied types of tumors：ulcerative type in 9 cases,infiltrating type in 2 cases,and protrusive type in 2 cases,nodular type in 1 case.The diagnostic rate of endoscopic biopsy is 35.7%.[Conclusions] The manifestation of tumor of the blood system which happened in the gut primarily is not typical.The endoscopic features are variable.To improve endoscopic diagnostic rate,it is important to improve the understanding of the endoscopic performance and take multi-site and deep biopsy.