结外淋巴瘤79例误诊分析

目的:探讨79例结外淋巴瘤的发病情况、误诊原因及防范对策。方法:对79例结外淋巴瘤的临床资料进行回顾性分析。结果:79例(包括胃肠道、鼻咽、中枢神经系统、腮腺等部位)患者常误诊为相应部位的炎症或其他肿瘤。本病误诊率为87.3%,误诊原因为①临床少见,临床医生注意不够。②临床表现缺乏特异性。③专科医师知识面窄,满足于本专业疾病的诊断。④病理科医师对本病的认识不够,未进行必要的免疫组化检查。⑤内镜检查及影像学检查无特异性。⑥取材不佳。结论:提高对本病的认识、详细询问病史及体格检查、对于低分化或未分化癌以及鼻咽部肿物常规行免疫组化检查、加强临床与病理科医师的沟通、正确的取材等有助于减少误诊的发生。

Analysis of Misdiagnosis Extra-nodal Malignant Lymphoma in 79 cases

Objective: To observe the incidence rate and causes of misdiagnosis in 79 cases with extra-nodal malignant lymphoma.Methods: The clinical data of 79 cases was analysed retrospectively.Results: Among the 79 cases,diseased region included gastrointestinal tract,nasopharynx,central nervous system and parotid,etc.These cases were misdiagnosed as inflammation and cancer of correlative part.The causes of misdiagnosis induded the low incidence rate,lack of specialties in clinical represent,specialist's narrow knowledgement,lack of immunohistochemistry tect and disqualified samples.Conclusion: There is a high ratio of misdiagnosis of extra-nodal malignant lymphoma.Learning more about the disease,asking more medical histories,doing completely physical examination and immunohistochemcistry test,more communication with pathologist and getting qualified samples can decrease the ratio of misdiagnosis.