原发性小肠淋巴瘤诊断及外科治疗

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1、原发性小肠淋巴瘤诊断及外科治疗【摘要】目的探讨原发性小肠淋巴瘤（primarysmallintestinelymphoma，PSIL）的临床表现、CT特点，提出临床策略。方法回顾性分析2003年1月至2007年7月收治的15例PSIL的患者临床资料。结果15例患者中男9例，女6例，平均51.6岁。PSIL常见的临床表现为：腹痛、腹部肿物、肠梗阻、消化道出血及消瘦；血CEA、CA199均正常。术前15例均行CT检查，CT初诊检出肿瘤15例，定性诊断准确12例；15例中，11例行消化道钡餐检查，4例检出病变，仅1例提示淋巴瘤可能。15例

2、患者均行手术治疗，无围手术期死亡，术后病理结果为PSIL，术后1年生存率为85.7%。结论PSIL无特异性临床症状，消化道钡餐诊断率低，CT扫描具有一定的特征，结合临床具有较高的诊断价值。早期诊断对改善PSIL的预后十分重要，积极手术切除和辅助化疗可以获得良好效果。【关键词】淋巴瘤；小肠；诊断DiagnosisandsurgicaltreatmentofprimarysmallintestinelyphomaHUANGGui-tian,XUBo.EmergencyDepartment,GuangzhouCityIstPeople’s

3、Hospital,Guangdong51000,China11【Abstract】ObjectiveToapproachthediagnosisandtreatmentofprimarylymphomaofthesmallintestine.MethodsTheclinicaldataof15patientswithprimarylymphomaofthesmallintestinefromJanuary2003toJuly2007werereviewed.ResultsOfthe15cases,9casesweremaleand6

4、caseswerefemale,theaverageagewas51.6years.Thecommonestclinicalmanifestationwereasfollow:abdominalpain,abdominallump,bowelobstruction,alimentarytracthemorrhageandathrepsy.CEAandCA199valuesofbloodserumwerenormal.AllofthesecaseswereunderwentCTscanningbeforeoperation.In12o

5、f15caseswerefinaldiagnosisedbyCTscanning.11casesweresubjectedtoBa-mealexaminations.Positiveresultswerefoundin4cases，andonly1casewasconsideredtobePSIL.Allofthemreceivedsurgicaloperation.Thepostoperativepathologyofallthepatientswereprimarysmallintestinelymphoma.The1yearp

6、ostoperativesurvivalratewas85.7%.ConclusionPSILhadnospecificityclinicalmanifestation.Bariumstudyhadhypo-diagnosis11ratio,CTscanhadspecificdiagnosticcharacteristicsforPSIL.IncombinationwithCTscanandclinicalmanifestationexaminationsaremutuallybeneficialinthediagnosticpro

7、cess.Mostofthepatientswithprimarylymphomaofthesmallintestinewereinadvancedstageswhenoperatedordiagnosed,soearlydiagnosisandcomprehensivetherapywerethekeytoamelioratethepatients’prognosis.【Keywords】Lymphoma;Smallintestine;Imagingdiagnosis原发性小肠淋巴瘤（primarysmallintestinely

8、mphoma，PSIL）是较少见的消化道恶性肿瘤，起病隐匿，临床表现缺乏特征性，易于误诊。现收集本院2003年1月至2007年7月收治的PSIL15例，本文将结合其临床表现特征和CT特点进行综合分析、诊断并提出临床对策。1资料与方法1