小肠克罗恩病与小肠MALT淋巴瘤的临床和病理分析

Analysis of Clinical and Pathological Features of Patients with Crohn's Disease and Mucosa-associated Lymphoid Tissue Lyphoma in Small Bowel Diseases

目的:分析小肠克罗恩病(CD)与小肠MALT淋巴瘤的临床资料,以提高两者的鉴别诊断水平。方法:回顾性分析经手术确诊的小肠CD与MALT淋巴瘤患者的临床表现、术中所见及病理结果。结果:腹痛是这两组最常见的临床表现。8例(40%)小肠CD出现肠腔狭窄,2例(10%)伴肠瘘形成;3例小肠MALT淋巴瘤为肿块型(50%);11例(55%)CD出现透壁性炎症,10例(50%)出现镜下溃疡,3例(15%)表现为非干酪样肉芽肿;B细胞性淋巴瘤5例(83.3%)。结论:小肠CD以纵行溃疡为主,伴肠腔狭窄、肠瘘形成,小肠MALT淋巴瘤以肿块型为主,以B细胞性为主。

Objective：To investigate the clinical data of patients with Crohn＇s disease （CD） and mucosaassociated lymphoid tissue （MALT） lyphoma in small bowel, so as to improve the skill of different diagnosis of both. Methods：The clinical features, intro-operation findings and histopathologic characteristics of patients with CD and MALT lymphoma were reviewed retrospectively. Results： Abdominal pain was the most common symptom in the two groups. Intestinal stricture was observed in 8 （40%） and intestinal fistula in 2 （10%） patients with CD. 3 cases with MALT lymphoma manifested as mass （50%）. Transmural inflammation （11 cases, 55%）, ulcer （10cases, 50%） and noncaseous granuloma （3 casses, 15%） were observed in patients with CD. 5 patients （83.3%） with MALT lymphom were B cell lymphoma. Conclusions： Most of CD manifeste as slit ulcer, with intestinal stricture and internal fistula, and most of MALT lymphoma manifeste as mass and B cel1 lymphoma.