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目的:探讨原发性胃恶性淋巴瘤primarygastricmalignantlymphomaPGML)的临床表现、内镜和病理特点。方法:统计30例PGML患者的临床表现及X线检查、内镜检查、病理检查的特点并进行分析。结果:30例PGML中临床表现以腹痛、体重下降、发热、腹块、恶心、呕吐、上消化道出血为主。病变主要位于胃体(73.3%)。内镜下表现为隆起型14例(46.7%),溃疡型12例(40.0%),浸润型4例(13.3%),内镜活检与术后病理符合率为80.0%。肿瘤起源于B淋巴细胞27例(90.0%),其中19例为胃粘膜淋巴组织相关淋巴瘤,T淋巴细胞3例(10.0%)。本病手术切除术率高,对化疗、放疗均较敏感。结论:PGML以腹痛、体重下降、发热、上消化道出血为主要表现,以胃体发生率最高。内镜及大体分型的隆起型及溃疡型为多见,病理特点以B淋巴细胞为主。原发性胃恶性淋巴瘤由于其发病率低,临床表现特殊,易造成漏诊,内镜为诊断PGML的有效手段。手术、化疗和放疗等综合治疗是提高生存率的有效途径。
Objective: To investigate the clinical manifestations, endoscopic and pathological characteristics of primary gastric malignant lymphoma primarygastricmalignant lymphoma (PGML). Methods: The clinical manifestations of 30 patients with PGML and the features of X-ray examination, endoscopy, and pathological examination were analyzed and analyzed. Results: The clinical manifestations of 30 cases of PGML were abdominal pain, weight loss, fever, abdominal mass, nausea, vomiting and upper gastrointestinal bleeding. The lesions were mainly located in the corpus (73.3%). Under endoscopy, there were 14 cases (46.7%) of uplift type, 12 cases (40.0%) of ulcer type, and 4 cases (13.3%) of infiltrative type. The coincidence rate between endoscopic biopsy and postoperative pathology was 80.0%. Tumors originated from 27 cases (90.0%) of B lymphocytes, of which 19 cases were gastric lymphoid tissue-associated lymphomas and T lymphocytes were 3 cases (10.0%). The surgical resection rate is high, and it is sensitive to chemotherapy and radiotherapy. Conclusion: PGML is mainly characterized by abdominal pain, weight loss, fever, upper gastrointestinal bleeding, and the highest incidence of gastric body. Endoscopic and gross classification of bulging type and ulcer type are more common, pathological features mainly B lymphocytes. Because of its low incidence and clinical manifestations, primary gastric malignant lymphoma can easily lead to missed diagnosis. Endoscopy is an effective means for diagnosing PGML. Comprehensive treatment such as surgery, chemotherapy and radiotherapy is an effective way to improve survival.