原发性小肠恶性淋巴瘤的诊治分析

Diagnosis and treatment of primary malignant lymphoma of the small bowel

目的 提高对原发性小肠恶性淋巴瘤的认识和诊治水平。方法 回顾分析我院 1 983年 1月～ 2 0 0 0年 5月收治的 1 3例原发性小肠恶性淋巴瘤患者的临床资料。结果 1 3例患者中 ,接受手术者 1 1例。 1 1例平均病程 2 1 .8个月 ;腹痛和体重下降是最常的症状 ;其中ⅡE 期 2例 ,ⅢE 期 6例 ,ⅣE 期 3例 ;肿瘤平均大小为 4 .85cm。肿瘤部位 :回盲部 7例 ,空肠 3例 ,十二指肠 1例。术后病理结果均为非何杰金恶性淋巴瘤 ,其中B细胞型 8例 ,混合细胞型 2例 ,T细胞型 1例。淋巴结转移率平均为 4 .2 /7.1。结论 本病病程较长 ,但确诊或手术时多数已属晚期 ,提高认识、早期诊断并选择以手术为主的综合治疗是提高本病疗效的关键。

Objective To improve the diagnosis and treatment of primary lymphoma of the small bowel.Methods The clinical data of 13 patients with primary lymphoma of the small owel from Jan 1983 to May 2000 were reviewed. Results Of the 13 cases, 11 received surgical operation. The average course of disease was 21.8 months. The commonest manifestations were abdominal pain and loss of body weight. Stage Ⅱ E was in 2 cases, Ⅲ E in 6 cases and Ⅳ E in 3 cases. The average size of the tumor was 4.85 in diameter. Seven lymphomas located at the ileo cecal portion, 3 at the jejunum and 1 at the duodenum. The postoperative pathology of all the patients were non Hodgkin's lymphoma, 8 were B cell type, 2 mixed cell type and 1 T cell type. Conclusion Most of the patients with primary malignant lymphoma of the small bowel were in advanced stages when operated or diagnosed, so early diagnosis and comprehensive therapy were the key to ameliorate the patients' prognosis.