原发性小肠淋巴瘤30例诊治分析

目的:分析总结原发性小肠淋巴瘤,提高诊断及处理水平。方法:回顾性分析我院1991～2004年间30例原发性小肠淋巴瘤的临床病理特点。结果:隐性失血、脐周隐痛、腹部肿物、隐匿消瘦是原发性小肠淋巴瘤的最常见表现。术前确诊为小肠肿瘤43.3%。30例小肠淋巴瘤中66.7%(20/30)行小肠肿瘤根治术,16.7%(5/30)行减瘤荷手术,16.7%(5/30)行姑息手术。术后病理结果均为非霍奇金淋巴瘤,其中B细胞型27例,T细胞型3例,18例发生淋巴转移。术后1年总生存率为66.7%。结论:原发性小肠淋巴瘤是较少见消化道肿瘤,多种检查方法合理应用可提高术前确诊率、手术应行根治性切除术。

Diagnosis and treatment for primary small intestine lymphoma of 30 cases

Objective:To analyze and summarize the clinical and pathological features for primary smalt intestine lymphoma.Methods:30 cases with primary small intestine lymphoma from 1991 to 2004 were studied retrospectively.All patients were identified by postoperative histopathological examination.Results:The main clinical features of these patients consisted of occult bleeding in digestive tract,mild abdominal pain,abdominal mass and gradual losing of body weight.In all cases,43.3% patients had the definite diagnosis of small bowel tumor preoperatively.The 30 cases were respectively undergone curative operation(66.7%,20/30),resection main tumor(16.7%,5/30)or palliative operation(16.7%,5/30)including gut bypass,biopsy and laparotomy.The postoperative pathology of all the patients was non-Hodgkin's lymphoma,27 were B cell type,3 were T cell type.There were 18 cases with regional node metastases by pathologic examination.Overall 1-year survival rate was 66.7%.Conclusion:Primary small intestine lymphoma is rare tumors of alimentary tract.The preoperative diagnosis accuracy can be improved by appropriate application of instrument.The radical operation might be the best decision.