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恶性淋巴瘤原发结外病变多见于非何杰金氏淋巴瘤,原发于大肠相当少见.本组18例均经手术及组织学证实,各例符合Dawson诊断标准1 临床资料18例中男12例,女6例;年龄15～80岁,平均46岁.各例均有腹痛、大便习惯改变.消瘦、乏力、贫血8例,不规则发热5例,右下腹包块9例.合并肠梗阻6例,下消化道出血13例,低血容量休克2例,腹膜炎2例.术前10例行钡剂灌肠或全消化道钡餐,10例行纤维结肠镜检查、钡餐灌肠见肠壁粘膜破坏,粘膜纹理中断.肠壁僵直、狭窄,扩张受限.肠腔有多个大小不等的充盈缺损,呈鹅卵石样改变,病变范围较大.纤维结肠镜检查2例因肠道出血妨碍观察,6例发现不规则隆起包块,延伸范围较大,2例溃疡性改变.其中3例为多发病灶.活检3例见异形细胞.2例证实恶淋.
Malignant lymphoma primary extranodal lesions are more common in non-Hodgkin’s lymphoma, the primary origin in the large intestine is quite rare. 18 cases of this group were confirmed by surgery and histology, each case is consistent with Dawson diagnostic criteria 1 clinical data in 18 cases of male 12 cases, female 6 cases; aged 15 to 80 years old, average 46 years old. Each case had abdominal pain, changes in bowel habits. Wasting, fatigue, anemia in 8 cases, 5 cases of irregular fever, 9 cases of right lower quadrant mass. Obstruction in 6 cases, 13 cases of lower gastrointestinal bleeding, 2 cases of hypovolaemia shock, 2 cases of peritonitis. 10 cases of preoperative barium enema or barium meal in the digestive tract, 10 cases of colonoscopy, barium meal enema see the intestinal mucosa Destruction, mucosal texture disruption, intestinal wall stiffness, stenosis, limited expansion. Intestinal cavity has a variety of filling defects of varying size, was a cobblestone-like change, a larger lesion. 2 cases of colonoscopy examination due to intestinal bleeding , 6 cases found irregular bump mass, extended range, 2 cases of ulcerative changes. 3 cases of multiple lesions. Biopsy 3 cases see abnormal cells.