胃黏膜相关淋巴组织淋巴瘤26例内镜与病理分析

Endoscopy and pathology of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue lymphoma

目的探讨胃黏膜相关淋巴组织边缘区(MALT)淋巴瘤的内镜表现及病理特征,提高其在内镜下的确诊率。方法回顾并总结2000-2012年我院经病理证实的26例胃MALT淋巴瘤患者临床内镜和病理资料。结果 26例患者平均年龄59.3岁,男女比1.6:1。患者症状不具有特异性,上腹不适是其最常见表现。病变累及胃体13例,胃窦5例,多部位者8例。内镜下表现为糜烂溃疡型13例,弥漫浸润型9例,结节隆起型4例。26MALT淋巴瘤中18例伴幽门螺杆菌(Hp)感染(69.2%)。结论胃MALT淋巴瘤发病老年男性居多,临床症状不典型。内镜下形态差异很大,范围广、病灶多是其特点。常规内镜多点深凿活检结合组织病理学、分子生物学检查,有助于提高胃MALT淋巴瘤的诊断确诊率。

Objective To investigate the endoscopic and pathological features of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue （MALT） lymphoma,and to improve its endoscopic diagnosis.Methods The endoscopic and pathological data of 26 cases of gastric MALT lymphoma confirmed pathologically from the 2000 to 2012 was retrospectively analyed.Results The average age of the patients was 59.3 years old （in the range of 40～76）,and the male to female ratio was 1.6：1.The patient＇s symptoms are non-specific,and epigastric discomfort is the most common manifestation.Lesions were found to involve gastric body in 13 cases,gastric antrum in 5 cases,and multi-sites in 8 cases.Endoscopic performance showed erosion ulcer in 13 cases,diffuse infiltration in 9 cases,nodules uplift in 4 cases.Of the 26 patients,18 were found with Helicobacterpylori （Hp） infection （69.2％）.Conclusion Gastric MALT lymphoma mostly occur in old men,with non-specific symptoms and many lesions,which exhibit great difference in morphology.Conventional endoscopic deep chisel biopsy combined with tissue pathology and molecular biology check help to improve the diagnosis of gastric MALT lymphoma.