摘要
目的：了解原发性肠道T细胞淋巴瘤的临床特点.方法：10年来收治恶性淋巴瘤173例,其中胃肠道淋巴瘤68例,占39.3%.而原发性肠道T细胞淋巴瘤11例占16.2%,现对其病史资料进行回顾性分析.结果：本组原发性肠道T细胞淋巴瘤患者年龄31～75岁,男女比例为8：3.病变多位于空、回肠,可有结肠累及.临床表现以腹痛、腹泻、发热、消瘦为主,部分患者并发肠穿孔、肠梗阻、消化道出血,无患者伴有乳糜泻.内镜下3例患者表现为溃疡病灶,术中见溃疡6例,肿块4例.4例曾被误诊为炎症性肠病.淋巴瘤细胞的免疫表型为白细胞共同抗原（LCA）（＋）、CD45RO（＋）、CD3（＋）、CD30（-）.所有患者均接受手术治疗,部分结合术后化疗.3例患者于术后3个月内死亡.结论：不伴有乳糜泻是本组原发性肠道T细胞淋巴瘤的特点之一.患者的临床表现以一些非特异性症状为主,常被误诊为炎症性肠病.内镜活检和手术标本的病理学检查是目前确诊原发性肠道T细胞淋巴瘤的主要依据.该病预后极差.
Objective：To analyze the clinical characteristics of primary intestinal T-cell lymphoma. Methods： All 11 cases of primary intestinal T-cell lymphoma admitted in Yangjiang Hospital from January 1999 to January 2009 were collected and analyzed retrospectively. Results： The age of the patients enrolled in this study ranged from 31 to 75 years,among them,8 were males and 3 female. The tumor mainly occurred in the jejunum or ileum,and might occur in the colon. The main clinical manifestations were abdominal pain, diarrhea, fever, weight loss, and might be complicated by intestinal perforation, obstruction or gastrointestinal hemorrhage. No patient was accompanied by celiac disease. The tumor was presented as multiple ulcers endoscopically in 3 patients, ulceration was seen in 6 and a mass in 4 during the operation. Four patients had been misdiagnosed as inflammatory bowel disease （IBD）. The immunophenotype of the tumor cells were leucocyte common antigen （LCA） （ ＋ ）, CD45RO （ ＋ ）, CD3 （ ＋ ）, CD30 （ - ） . All 11 patients received surgical operation, some with combined postoperative chemotherapy. Three patients died within 3 months after operation. Conclusions： In the present study, patients with primary intestinal T-cell lymphoma are not accompanied by celiac disease. The clinical manifestations are not specific,which is difficult to be differentiated from IBD. The definite diagnosis depends on the pathological examination of endoscopic biopsy specimens or surgical specimens. The prognosis of the disease is poor.
出处
《广州医学院学报》
2010年第4期78-81,91,共5页
Academic Journal of Guangzhou Medical College
