小肠淋巴瘤的超声及大体病理特征分析

Ultrasonographic and General Pathologic Features Assessment of Small Intestinal Lymphoma

目的探讨小肠淋巴瘤的超声及大体病理特征。方法回顾性分析北京协和医院1995年1月至2011年12月收治的19例经内镜或手术病理证实的小肠淋巴瘤的超声及病理特征。结果 19例均为非霍奇金淋巴瘤,回肠14例,十二指肠3例,回盲部2例。小肠淋巴瘤超声表现为肿块型(12例,12/19)、肠壁增厚型(1例,1/19)及非特异性腹部超声征象(6例,6/19)。肿块型表现为腹腔内实性、囊实性低回声(包括极低回声),边界清晰,体积较大时血流信号较丰富;浸润型表现为肠壁增厚,呈低回声(包括极低回声),后方回声增强。非特异性腹部超声征象包括肠管扩张,肠系膜淋巴结肿大等。大体病理主要表现为肠壁隆起于黏膜的肿块或肠壁环周增厚。结论小肠淋巴瘤具有典型的超声特征,超声在小肠淋巴瘤的诊断中可以提供有价值的诊断信息。

Objective To study the ultrasonographic and morphologic features of intestinal lymphoma. Methods The ultrasonographic and morphologic features of 19 patients with intestinal lymphoma were retrospectively analyzed. Results All the patients were confirmed as non-Hodgkin＇ s lymphoma by endoscopy or pathology. Of these 19 cases, the involved locations included ileum （n = 14）, duodenum （n =3）, and ileocecum （n =2）. The main sonographic types included mass type （ n = 12）, bowel wall thickening type （ n = 1 ）, and nonspecific signs （n = 6） . The mass type was characterized by solid and cystic-solid hypoechoic （ including marked hypoe- choic） foci, with well-defined margin, and rich blood signals were visible in large masses. The bowel wall thick- ening type was characterized by the thicking of bowel walls, showing hypoechoic （including marked hypoechoic）, along with posterior acoustic enhancement. The nonspecific signs included a g. dilatation of intestine and mesenter- ic lymph node enlargement. Morphologically, the tumor was featured by intestinal mass in intestinal mucosa or the cir- cumferential thickening of intestinal wall. Conclusion Small intestinal lymphoma has typical ultrasonographic features, and ultrasonography can provide useful information in the diagnosis of small intestinal lymphoma.