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目的探讨原发性小肠淋巴瘤(primary small intestine lymphoma,PSIL)的临床表现、CT特点,提出临床策略。方法回顾性分析2003年1月至2007年7月收治的15例PSIL的患者临床资料。结果15例患者中男9例,女6例,平均51.6岁。PSIL常见的临床表现为:腹痛、腹部肿物、肠梗阻、消化道出血及消瘦;血CEA、CA199均正常。术前15例均行CT检查,CT初诊检出肿瘤15例,定性诊断准确12例;15例中,11例行消化道钡餐检查,4例检出病变,仅1例提示淋巴瘤可能。15例患者均行手术治疗,无围手术期死亡,术后病理结果为PSIL,术后1年生存率为85.7%。结论PSIL无特异性临床症状,消化道钡餐诊断率低,CT扫描具有一定的特征,结合临床具有较高的诊断价值。早期诊断对改善PSIL的预后十分重要,积极手术切除和辅助化疗可以获得良好效果。
Objective To investigate the clinical manifestations and CT features of primary small intestine lymphoma (PSIL) and to propose clinical strategies. Methods The clinical data of 15 patients with PSIL admitted from January 2003 to July 2007 were retrospectively analyzed. Results 15 patients were 9 males and 6 females, average 51.6 years old. PSIL common clinical manifestations: abdominal pain, abdominal mass, intestinal obstruction, gastrointestinal bleeding and weight loss; blood CEA, CA199 were normal. Preoperative 15 patients underwent CT examination, 15 newly diagnosed tumors in CT, qualitative diagnosis of 12 cases; 15 cases, 11 cases of digestive tract barium meal examination, 4 cases detected lesions, only 1 case suggested that lymphoma. All 15 patients underwent surgical treatment without perioperative death. The postoperative pathological findings were PSIL. The 1-year survival rate was 85.7%. Conclusion PSIL has no specific clinical symptoms, low digestive tract barium meal diagnosis, CT scan has certain characteristics, combined with clinical diagnosis has a high value. Early diagnosis of PSIL to improve the prognosis is very important, and positive surgical resection and adjuvant chemotherapy can achieve good results.