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胃肠道淋巴瘤病变,包括原发性胃肠道淋巴瘤和恶性淋巴瘤胃肠受侵二类,前者文献报道较多,后者文献报道较少。1997年8月至1998年6月,我院对8例有消化道症状的非何杰金淋巴瘤(non-Hodgkin lymphoma,NHL)患者进行了内镜检查,发现NHL胃肠受侵3例,现报告如下。1 临床资料1．1 NHL胃受侵1例患者男性,62岁,因咽部异物感就诊。查体发现左扁桃体肿物,大小2cm×1.5cm。病理检查:弥漫型NHL,无裂细胞性。入院时临床分期:Ⅱ期。经放射治疗2个月后,排黑便3次,大便隐血试验(＋＋)。电子胃镜检查:胃体小弯、前壁多发性病变,形态不一,界限清晰,粘膜皱襞肥厚、粗糙,表面有糜烂、溃疡,大小1cm×(1.8cm~2cm)×3cm,活检组织无弹性。病理报告:弥漫型NHL胃浸润。胃镜后临床分期:Ⅳ期。经Vp16加CHOP方案化疗4周期,胃内病灶消失。
Gastrointestinal lymphoma pathological changes, including primary gastrointestinal lymphoma and malignant lymphoma, have been reported as gastrointestinal invaders. The former is more reported in the literature and the latter is less reported in the literature. From August 1997 to June 1998, 8 cases of patients with non-Hodgkin lymphoma (NHL) with gastrointestinal symptoms were examined by endoscopy and 3 cases of gastrointestinal invasiveness of NHL were found. The report is as follows. 1 clinical data 1.1 NHL stomach infiltration of a male patient, 62 years old, due to foreign body sensation in the throat. Physical examination revealed a left tonsil mass with a size of 2 cm x 1.5 cm. Pathological examination: diffuse NHL, non-cleaved cell. Clinical stage at admission: Phase II. After 2 months of radiotherapy, black stools were discharged 3 times and fecal occult blood test (++). Electronic gastroscopy: small curvature of the gastric body, multiple lesions of the anterior wall, different shapes, clear boundaries, hypertrophy and roughness of mucosal folds, erosion, ulceration on the surface, size 1cm×(1.8cm~2cm)×3cm, inelastic biopsy . Pathology report: diffuse NHL gastric infiltration. Endoscopic staging: IV. After 4 cycles of Vp16 plus CHOP regimen, gastric lesions disappeared.