CAJ | 학술논문

目的提高对以肺部症状为首发的肠病型T细胞淋巴瘤的认识.方法收集2例以肺部症状首发的肠病型T细胞淋巴瘤,并结合相关文献对其临床表现、诊断思路及治疗方法进行分析总结.结果仅以肺部症状首发的肠病型T细胞淋巴瘤较为少见,不易诊断.临床表现主要为反复无规律性发热、咳嗽,后期可伴腹部症状(肠出血、肠穿孔).纤维支气管镜和经皮肺穿刺活检往往难以诊断,确诊需腹部手术探查取活组织行病理学及免疫组化分型.治疗方面仍存在争议.结论当以肺部症状为首发表现,行抗感染等经验性治疗无效,而多次肺组织活检又无阳性结果时,应考虑全身性疾病的可能性,尤其在出现肠出血或肠穿孔等肠道症状时,更应警惕肠病型T细胞淋巴瘤的诊断.争取早期确诊、早期治疗,提高患者生存率.
목적 제고대이폐부증상위수발적장병형T세포림파류적인식.방법 수집2례이폐부증상수발적장병형T세포림파류,병결합상관문헌대기림상표현、진단사로급치료방법진행분석총결.결과 부이폐부증상수발적장병형T세포림파류교위소견,불역진단.림상표현주요위반복무규률성발열、해수,후기가반복부증상(장출혈、장천공).섬유지기관경화경피폐천자활검왕왕난이진단,학진수복부수술탐사취활조직행병이학급면역조화분형.치료방면잉존재쟁의.결론 당이폐부증상위수발표현,행항감염등경험성치료무효,이다차폐조직활검우무양성결과시,응고필전신성질병적가능성,우기재출현장출혈혹장천공등장도증상시,경응경척장병형T세포림파류적진단.쟁취조기학진、조기치료,제고환자생존솔.
Objective To recognize the cases of enteropathy-type T-cell lymphoma (ETCL) with pulmonary complications primarily appeared. Methods Two cases of ETCL with pulmonary complications primarily were collected and relevant literatures were reviewed. The clinical features, diagnosis and treatment of the disease were analyzed. Results ETCL with pulmonary complications primarily appeared was so rare that it was difficult to be diagnosed. The main clinical features were repeated irregular fever and cough with abdominal symptoms which may be intestinal hemorrhage or perforation in the later period. Confirmed diagnosis depended on pathology and immunohistochemistry following laparotomy since it tended to be hard by fiberoptic bronchoscope or percutaneous lung biopsy. There was no consensual treatment currently. Conclusions The possibility of systemic disease should be prospected when pulmonary complications primarily appear with the inefficacy of conventional therapy and the negative results of the biopsy for several times. More attention could be paid to the diagnosis of ETCL especially when intestinal hemorrhage or perforation occurs. The earlier diagnosis and treatment are urgently required to improve the prognosis of these patients.