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目的 :探讨原发性大肠恶性淋巴瘤内镜表现特征及结肠镜检查对本病的诊断价值。方法 :总结近 5年来我院经手术及病理证实的 7例原发性大肠恶性淋巴瘤的临床和内镜资料。结果 :位于盲肠占 57.1 % ,直肠占2 8.6 % ,病灶呈局限性分布 6例 ,累及肠管平均 7.6cm长 ,1例为多发性跳跃式分布 ;内镜下表现为弥漫型 4例 ,息肉型 3例 ,溃疡 2例 ,结肠镜检查 (结合病理学诊断 )确诊率达 75 .0 % ,明显高于 (P <0 .0 1 )钡灌肠诊断。结论 :本病好发于盲肠 ,其次是直肠 ;内镜下以弥漫型多见 ,病变累及范围广 ,粘膜皱褶肥厚如脑回状、病灶复合多发等表现颇具特征性 ;结肠镜检查是诊断本病的主要方法 ;内镜活检至粘膜下、多点取材和加做免疫组化检查能提高内镜诊断的准确性。
Objective: To investigate the endoscopic features of primary malignant lymphoma and the diagnostic value of colonoscopy in this disease. Methods: To summarize the clinical and endoscopic data of 7 cases of primary malignant lymphoma of the large intestine confirmed by operation and pathology in our hospital in recent 5 years. Results: The caecum was 57.1%, the rectum was 8.66%, the lesions were localized in 6 cases, involving an average of 7.6cm long intestine, 1 case of multiple leapfrog distribution; endoscopic showed diffuse in 4 cases, polypoid 3 cases, 2 cases of ulcer, colonoscopy (combined with pathological diagnosis) diagnosis rate of 75.0%, significantly higher (P <0.01) barium enema diagnosis. Conclusion: The disease occurs mainly in the cecum, followed by the rectum; diffuse more common endoscopic findings, lesions involving a wide range of mucosal folds hypertrophy, such as brain back like, multiple lesions and so quite characteristic performance; colonoscopy is a diagnosis The main method of this disease; endoscopic biopsy to submucosal, multi-point and plus do immunohistochemistry can improve the accuracy of endoscopic diagnosis.