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一、概述胃肠道淋巴瘤指胃肠道原发性恶性淋巴瘤(primarygas-trointestinallymphoma,PGIL),是最常见的来源于结外淋巴组织的非霍奇金淋巴瘤(non—Hodgkin’slymphoma,NHL),约占结外淋巴瘤30%。近年来,由于EB病毒和Hp感染的患者增多,加之自身免疫性疾病和继发性免疫功能异常病例的增加,PGIL的发病率有上升的趋势。由于淋巴结原发的恶性淋巴瘤可远处播散至胃肠道,因此胃肠道原发恶性淋巴瘤的诊断应具备以下条件:(1)体表淋巴结无病变;(2)血液白细胞计数正常;(3)纵膈淋巴结无病变;(4)诊断时胃肠道及其所属淋巴结以外的部位无肉眼可见病变;(5)肝脾正常。免疫组化、分子生物学等技术的应用,提高了人们对胃肠道淋巴瘤发病机制、生物学行为等的认识,对其病理诊断及分类也有了一些新的变化。
First, an overview Gastrointestinal lymphoma Refers to the primary gastrointestinal tract of primary malignant lymphoma (primarygas-trointestinallymphoma, PGIL), is the most common non-Hodgkin lymphoma derived from extranodal lymphoid tissue (non-Hodgkin’s lymphoma, NHL), accounting for about 30% of extranodal lymphoma. In recent years, due to the increase of Epstein-Barr virus and Hp infection, combined with the increase of autoimmune diseases and secondary immune dysfunction cases, the incidence of PGIL is on the rise. As the primary lymph node lymphoma disseminated to the gastrointestinal tract at a distance, so the diagnosis of gastrointestinal primary malignant lymphoma should meet the following conditions: (1) no lymph node body surface lesions; (2) normal blood leukocyte count ; (3) mediastinal lymph node disease-free; (4) diagnosis of gastrointestinal and other non-lymph node sites outside the non-visible lesions; (5) normal liver and spleen. Immunohistochemistry, molecular biology and other technologies to improve people’s understanding of the pathogenesis of gastrointestinal lymphoma, biological behavior, etc., its pathological diagnosis and classification also has some new changes.