21例原发性胃恶性淋巴瘤临床诊治分析

目的探讨原发性胃恶性淋巴瘤的诊断、治疗与预后。方法回顾性分析21例经内镜及手术病理确诊的原发性胃恶性淋巴瘤患者临床、胃镜、上消化道钡餐及病理资料。结果原发性胃恶性淋巴瘤临床无特异性，内镜下病变可累及多部位，表现为溃疡型、肿块型、弥漫型及结节型，病变范围较大、形态多样、多灶损害为特征。上消化道钡餐检查表现缺乏特异性，与胃癌、胃溃疡、胃炎等鉴别困难。结论原发性胃恶性淋巴瘤临床缺乏特异性表现，内镜及上消化道钡餐检查下表现多样，误诊率高。

Clinical Analysis of 21 Patients with Primary Gastric Malignant Lymphoma

Objective To explore the diagnosis,treatment and prognosis of primary gastric malignant lymphoma.Methods 21 cases of primary gastric malignant lymphoma were retrospectively analyzed by endoscopic and surgical pathological diagnosis with clinical data,upper gastrointestinal barium,gastroscope and pathology data.Result Clinical symptoms of primary gastric malignant lymphoma have no specificity.Endoscopic characteristics includes multifocal lesion,morphological diversity and large range.Endoscopic classification includes ulcer type,mass type,diffuse type and nodular type.The differential diagnosis between primary gastric malignant lymphoma and many diseases is very difficult due to lacking specificity by upper gastrointestinal barium. Conclusions Typical presentation is still lacking for prognosis of primary gastric malignant lymphoma.Early diagnosis and resection plus systemic chemotherapy or radiotherapy and therapeutic schedule may improve the survival rate of patients.