中国血液流变学杂志
中國血液流變學雜誌
중국혈액류변학잡지
CHINESE JOURNAL OF HEMORHEOLOGY
2014年
4期
506-508,512
,共4页
肠道淋巴瘤%T细胞%回顾性分析
腸道淋巴瘤%T細胞%迴顧性分析
장도림파류%T세포%회고성분석
intestinal lymphoma%T-cell%retrospective analysis
目的：分析肠道T细胞淋巴瘤的临床特点及病理特点。方法对2004年1月～2014年4月13例术后病理确诊为肠道T细胞淋巴瘤的病史资料进行回顾性分析。结果该组13例肠道T细胞淋巴瘤男女性别无明显差异，20～30岁、40～50岁及60岁以上发病率较高，中位年龄为49岁，病变多位于空、回肠，结直肠少见。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。13例肠道T细胞淋巴瘤患者中10例行腹部CT检查，3例行肠镜检查，3例肠镜检查中1例提示肠道肿瘤，2例提示肠道炎性改变或息肉。1例小肠三维重建CT提示小肠淋巴瘤可能。所有患者均接受手术治疗并通过病理确诊，病理分型中外周T细胞型淋巴瘤5例，NK/T细胞型淋巴瘤5例，肠型T细胞淋巴瘤3例。免疫表型13例CD3及CD45-RO均呈阳性表达，Ki-67呈不同程度阳性。结论肠道T细胞淋巴瘤早期诊断困难，误诊和漏诊率高，患者的临床表现以一些非特异性症状为主，内镜活检和手术标本的病理学检查是目前确诊肠道T细胞淋巴瘤的主要依据。
目的：分析腸道T細胞淋巴瘤的臨床特點及病理特點。方法對2004年1月～2014年4月13例術後病理確診為腸道T細胞淋巴瘤的病史資料進行迴顧性分析。結果該組13例腸道T細胞淋巴瘤男女性彆無明顯差異，20～30歲、40～50歲及60歲以上髮病率較高，中位年齡為49歲，病變多位于空、迴腸，結直腸少見。臨床錶現以腹痛、腹瀉、髮熱、消瘦為主，部分患者併髮腸穿孔、腸梗阻、消化道齣血。13例腸道T細胞淋巴瘤患者中10例行腹部CT檢查，3例行腸鏡檢查，3例腸鏡檢查中1例提示腸道腫瘤，2例提示腸道炎性改變或息肉。1例小腸三維重建CT提示小腸淋巴瘤可能。所有患者均接受手術治療併通過病理確診，病理分型中外週T細胞型淋巴瘤5例，NK/T細胞型淋巴瘤5例，腸型T細胞淋巴瘤3例。免疫錶型13例CD3及CD45-RO均呈暘性錶達，Ki-67呈不同程度暘性。結論腸道T細胞淋巴瘤早期診斷睏難，誤診和漏診率高，患者的臨床錶現以一些非特異性癥狀為主，內鏡活檢和手術標本的病理學檢查是目前確診腸道T細胞淋巴瘤的主要依據。
목적：분석장도T세포림파류적림상특점급병리특점。방법대2004년1월～2014년4월13례술후병리학진위장도T세포림파류적병사자료진행회고성분석。결과해조13례장도T세포림파류남녀성별무명현차이，20～30세、40～50세급60세이상발병솔교고，중위년령위49세，병변다위우공、회장，결직장소견。림상표현이복통、복사、발열、소수위주，부분환자병발장천공、장경조、소화도출혈。13례장도T세포림파류환자중10례행복부CT검사，3례행장경검사，3례장경검사중1례제시장도종류，2례제시장도염성개변혹식육。1례소장삼유중건CT제시소장림파류가능。소유환자균접수수술치료병통과병리학진，병리분형중외주T세포형림파류5례，NK/T세포형림파류5례，장형T세포림파류3례。면역표형13례CD3급CD45-RO균정양성표체，Ki-67정불동정도양성。결론장도T세포림파류조기진단곤난，오진화루진솔고，환자적림상표현이일사비특이성증상위주，내경활검화수술표본적병이학검사시목전학진장도T세포림파류적주요의거。
Objective To investigate the clinical and pathologic features of intestinal T-cell lymphoma. Methods 13 patients who were diagnosed with intestinal T-cell lymphoma during January 2004 to April 2014 in our hospital were retrospectively analyzed.Results The incidence of intestinal T-cell lymphoma was not significantly different between male and female, 20~30 and 40~50 years of age and older have a higher prevalence, with a median age of 49 years. The lesions were located in the jejunum and ileum, colorectal rare. The clinical symptoms mainly manifested abdominal pain, diarrhea, fever, weight loss, some with intestinal perforation, intestinal obstruction, gastrointestinal bleeding. Ten of the thirteen patients underwent abdominal CT. One of three patients with routine colonoscopy was diagnosed intestinal cancer; the others were diagnosed infl ammatory bowel diseases or polyps. Especially one case of small bowel intestinal lymphoma were diagnosed by CT reconstruction. All patients underwent surgery and were confi rmed by pathology,fi ve cases of peripheral T-cell lymphoma,fi ve cases of NK/T-cell lymphoma, three cases of intestinal T-cell lymphoma. All the patients showed CD3 and CD45-RO positive-Phenotype, Ki-67-positive with varying degrees.Conclusion For non-specifi c symptoms, diffi culty early diagnosis and highly rate of misdiagnosis and missed diagnosis of intestinal T-cell lymphoma, endoscopic biopsy and surgical pathology specimens are currently pathways to diagnose intestinal T-cell lymphoma.
