经支气管镜治疗支气管肿瘤

经支气管镜治疗支气管肿瘤张保金，赵忠忱近十几年来经气管镜治疗的方法已有多种，技术亦日益提高，特别对气管支气管肿瘤的治疗更逐步普及，这是重新打开大气道的阻塞和狭窄，迅速缓解患者呼吸困难和濒临窒息的有效方法。一、适应症的选择：支气管肺癌开始均在支气管粘膜...

EVAIUATION OF ENDOSCOPY IN THE DIAGNOSIS OF PRIMARY GASTRIC MALIGNANT LYMPHOMA

primary gastric malignant lymphoma has been shown to have higher incidence in recent years. Since it is a kind of disease which lacks of specific clinical manifestations and endoscopic appearances ,its early diagnosis remains difficult. Retrospective study was made to evaluate endoscopic biopsies in 140 cases of pathologically diagnosed or suspicious gastric malignant lymphoma in the last 10 years. Among the 140 patients ,38 were finally diagnosed gastric malignant lymphoma,in which 19 had been formerly definitely diagnosed gastric malignant lymphoma while the other 19 had been described as suspicious malignant lymphoma , poorly differentiated adenocarcinoma , non differentiated cancer , ulcer and lymphotissue hyperplasia. Among the 38 cases ,male 22 ,female 16 ,aging from 1 6 to 82 (mean 47. 7).Main clinical manifestation was irregular abdominal pain (81% ). Other symptoms were upper abdominal discomfort ( 8/38 ) , anorexia ( 4/38 ) , hematemesis and/or hematochesia ( 5/38 ) , weight loss ( 7/38 ) and upper abdominal mass ( 2/38 ) . Endoscopic appearances were ulcerative lesions ( 12 cases ) ,diffusive infiltrative lesions ( 11 cases ) , masses ( 6 cases ) , huge folded lesions (4 cases ) and mixed lesions ( 5 cases ). No dominant sites of the disease were found and the sizes of the lesions were between 5 to 10 cm in most of the cases (22/38). Pathologic examination showed that 16 cases were mucosa-associated lymphotissue lymphoma (MALT )and 22 cases were non-MALTlymphoma. We conclude that primary gastric malignant lymphoma has the endoscopic characteristics of pleomorphism,multiple foci and diffusive lesions. Skillful and careful endocopy is very important in accurate diagnosis ,and in those endoscopic suspicious cases ,biopy should be taken deeply in more sites in order to make it easier to diagnose the disease.