胃肠道黏膜相关淋巴组织淋巴瘤六例报告及文献复习

Gastrointestinal mucosa-associated lymphoid tissue lymphoma (report of 6 cases with literatures review)

目的 报告 6例胃肠道黏膜相关淋巴组织 (mucosa associatedlymphoidtissue ,MALT)淋巴瘤并结合文献探讨其影像学表现。方法 搜集经病理证实的胃肠道MALT淋巴瘤 6例 ,其中来源于胃 4例 ,十二指肠及回肠各 1例 ,所有病例均经胃肠钡餐造影 (GI)、CT或MRI检查。并复习了近几年国内外文献报道的胃肠道MALT淋巴瘤的临床及影像学表现。结果 根据该组病例临床及影像学所见 ,胃肠道MALT淋巴瘤临床及影像学特征为 :(1)年龄在 5 0岁以上 ,多为Ⅰ～Ⅱ期低度恶性肿瘤 ,病程长 ,进展缓慢 ,症状轻 ,疗效好 ;(2 )绝大多数幽门螺杆菌阳性 ,特别是胃MALT淋巴瘤 ;(3)GI示胃小区不规则增宽 ,多发性黏膜下小结节和多发边缘模糊的浅表溃疡 ,胃肠道黏膜皱襞粗大、紊乱迂曲 ,晚期呈多发息肉样结节、肿块及较大溃疡。CT及MRI表现为胃肠道壁环形光滑或小结节样增厚 ,肠MALT淋巴瘤可致肠腔狭窄。多发细小黏膜下病灶及多种征象共存是该病最重要的影像学特点。结论 典型影像学表现结合临床表现 ,可作出胃肠道MALT淋巴瘤的诊断。

Objective To assess the imaging and clinical manifestations of gastrointestinal mucosa associated lymphoid tissue(MALT)lymphoma with review of literatures. Methods Six cases of gastrointestinal MALT lymphoma (4 in stomach and 2 in intestine) proved by surgery and biopsy were examined with gastrointestinal barium meal examination (GI), CT or MRI scans. Results Gastrointestinal MALT lymphoma was an indolent disease that patients had a slow natural course, a high response rate to treatment and a long survival. Most cases of gastrointestinal MALT lymphoma had associated with Helicobacter pylori. GI showed thickened folds, multiple mucosal nodularity or polypoid filling defects, multiple point ulcers, and enlarged areae gastricae. CT and MRI revealed diffuse gastrointestinal wall thickening, polypoid lesion, and abdominal lymphadenopathy.Two or more findings and multiplicity of lesions might be the most important imaging features. Conclusions Based on the typical imaging findings combined with clinical characteristics, gastrointestinal MALT lymphoma could be suggested.