原发性胃肠恶性淋巴瘤误诊研究.doc

原发性胃肠恶性淋巴瘤误诊研究[摘要] 目的：探讨原发性胃肠道恶性淋巴瘤的误诊原因。方法：对我科2000年5月~2006年7月收治的22例原发性胃肠道恶性淋巴瘤的临床资料进行回顾性分析。结果：22例均行胃肠镜及病理检查。其中，胃淋巴瘤15例：仅1例确诊，术前10例误诊为胃低分化腺癌，3例误诊为胃未分化腺癌，1例误诊为胃溃疡。肠淋巴瘤7例：也仅1例确诊，2例误诊为肠结核，4例误诊为腺癌。22例均行手术治疗，术后1例出现切口感染，1例出现肺部感染，并发症和其他手术相比无差异。经治疗后均全部顺利出院。术后给予化疗，无一例死亡。结论：原发性胃肠道恶性淋巴瘤误诊率高，手术和术后病理免疫组化检查是主要的确诊方法，手术联合化疗具有较好的疗效。 [关键词] 恶性淋巴瘤；外科手术；诊断 [中图分类号]R730.264[文献标识码]B[文章编号]1673-7210（2008）01（c）-110-02 Clinical misdignosis analysis of primary gastrointestinal m alignant lymphoma MAO Sheng-xun, YAN Gang. （Department of General Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 30006,China） [Abstract] Objective：To evaluate the cause of misdiagnosis primary gastrointestinal m alignant lymphoma(PGIML). Methods：A total of 22 patients with PGIML underwent operation in our department form May 2000 to July 2006 were reviewed retrospectively. Results：All of those patients had endoscopy and biopsy. Amony them 15 cases were gastric m alignant lymphoma.Only one case was confirmed the diagnosis of PGIML before operation. 10 cases were misdiagnosed as poorly differentiated adenocarcionoma. 3 cases were misdiagnosed as undifferential adenocarcinoma. 1 case was diagnosed as gastric ulcer.There were 7 cases intestinal lymphoma.Only one case was confirmed the diagnosis of PGIML before operation also. 2 cases were misdiagnosed as tuberculosis of intestine. 4 cases were misdiagnosed as adenocarcinoma.All those 22 cases patient had operation. 1 case had wound infection.All those patients were discharged successfully after surgery and chemotherapy, no case died. Compared to other operation, there was no difference in operative the complications. Conclusion：The misdiagnosed rate of PGIML is at a very high level before operation.Surgery pathology and immunohistochemistry after surgery are important methods to confirm the diagnosins of PGIML. Surger following combine with chemotherapy has a curative effect on PGIML. [Key words] M alignant lymphoma；Surgical pr