淋巴结外淋巴瘤的误诊分析与对策

Analysis on misdiagnosis of extranodal lymphomas

目的 对结外淋巴瘤的误诊原因分析并提出相应的防止对策。方法 自 1980年 1月至 2 0 0 0年 7月 ,对收治非霍奇氏淋巴瘤 85例患者进行回顾性分析。结果 85例非霍奇氏淋巴瘤中结外淋巴瘤 5 0例 ( 5 8.5 %) ,误诊 30例 ,误诊率高达 6 0 %。 30例中发生于消化道者最多 ,共 11例 ( 36 .6 %) ,其次为鼻及咽部组织 ,共 7例 ( 2 3.3%) ,其它部位少见共12例 ( 4 0 %)。结论 结外淋巴瘤误诊发生于消化道、鼻及咽部组织为多。但可发生于任何器官组织 ,其临床表现无特征性 ,诊断困难 ,易发生误诊。临床医师必须具有多学科横向知识 ,加强对结外淋巴瘤的认识 ,并尽快进行病理学检查。

Objective To increase the diagnostic accuracy,reduce the incidence of misdiagnosis and improve the prognosis for NHL.Methods From January 1980 to July 2000,85 patients with NHL treated in our hospital were analysed retrospectively.Results Fifty(58.8%) NHL patients were diagnosed as extranodal lymphomas.Thirty of 50 cases were midiagnosed.The misdiagnosis rate was 60%.11 cases occurred in gastrointestinal tract (36.6%),7 cases in nosal cavitary and pharynx(23.3%) and 12 cases in other organs(40%).Conclusion Extranodal lymphomas occur mostly in gastrointestinal tract?nasal cavitary and pharyngeal lymph tissue,as well as in any other organs and tissues without special features. Early diagnosis is difficult to make unless biopsy is carried out.