原发性胃恶性淋巴瘤内镜及病理特点分析

Endoscopic and pathological features of primary gastric malignant lymphoma

目的探讨原发性胃恶性淋巴瘤的内镜和病理特点。方法 60例经胃镜检查及组织病理学检查确诊为原发性胃恶性淋巴瘤患者,回顾性分析其内镜下表现及病理特点。结果内镜下表现为溃疡型病变32例(53.3%),浸润型病变14例(23.3%),肿块型病变7例(11.7%),结节型7例(11.7%);30例行超声胃镜检查,显示胃壁第2、3层呈低回声改变,且明显增厚;60例患者的组织病理结果均为B细胞型非霍奇金淋巴瘤,其中弥漫大B细胞淋巴瘤40例(66.7%),包括非生发中心来源22例和生发中心来源18例;结外黏膜相关淋巴组织边缘区淋巴瘤20例(33.3%)。结论原发性胃恶性淋巴瘤以溃疡型病变多见,内镜下形态具有多型性,病理类型表现多样。

Objective To investigate the endoscopic and pathologic features of primary gastric malignant lymphoma. Methods The endoscopic and pathologic features were retrospectively analyzed in 60 patients with primary gastric malignant lymphoma confirmed by gastroscopy and pathological examination. Results Endoscopic manifestations showed ulcerative lesion in 32 cases （53.3%）, invasive lesion in 14 cases （23.3%）, mass type lesion in 7 cases （11.7%） and nodular type 7 cases （11.7%）, and ulcerative lesion was the most common one. Thirty patients underwent endoscopic ultrasonography, showing hypoechoic changes and obvious thickening in the second and third layer of gastric wall. Pathological results of 60 cases were B cell type nowHodgkin＇s lymphoma, in which diffuse large B cell lymphoma was found in 40 cases （66.7 %） including 22 cases （55%） with non-germinal center origin and 18 cases （45 %） with germinal center origin, and lymphoma was found in the marginal zone of gastric mucosa associated lymphoid tissue in 20 cases （33.3%）. Conclusion Primary gastric malignant lymphoma, with the most common endoscopic demanifestation of ulcerative lesion, has endoscopic pleomorphism and various pathologic types.