论文部分内容阅读
大肠原发性恶性淋巴瘤在临床上较少见,我院共收治3例,现报告如下。例1:男,申某某,65岁,“因腹部不适6个月伴腹部剧裂疼痛1d”入院。查体:消瘦,急性痛苦面容,心肺正常,腹部隆起,腹胀紧张,全腹压痛及反跳痛,以麦氏点为主,肝浊音界消失,以肠穿孔而剖腹探查,见回盲部有6cm×6cm溃疡型肿块,其中有一3cm×3cm穿孔,距回盲部40、50和70cm处,分另U有5cm×5cm、5cm×4cm、3cm×4cm之溃疡形肿物,并粘连于回盲部,行右半结肠及部分小肠切除术,术后第2周发生吻合口漏,病理诊断,结肠非霍奇金病。术后1个月死亡。例2:男,杨某某,40岁,因“右下腹疼痛4d,加剧1d”入院,伴解粘液血便1次。查体:消瘦,急性痛苦貌,右下腹肌紧张,左下腹有压痛及反跳痛,未触及包块,肝浊音界存在;以急性阑尾炎并穿孔剖腹。探查所见回盲部有5cm×6cm的巨大溃疡、表面苍白、质偏软,其中有5cm×2cm穿孔而行右半结肠切除,探查标本:标本质硬,但偏软,面苍白,溃疡面与正常肠管无明显界限,病理:非霍奇金恶性淋巴病,T细胞来源,弥漫型。所取淋巴结未发现淋巴肿瘤细胞,术后第10天,骨髓相、血相中发现恶性组织细胞,术后1个月因高热致多器官功能衰竭而死亡。例3:男,何某某,43岁,因“间歇性右腹部疼痛半年,低热1个月”入院。入院钡灌肠示降结肠占位性病变,钡灌后?
Primary malignant lymphoma of the large intestine is rare in clinical practice. There are 3 cases treated in our hospital. The report is as follows. Example 1: Male, Shen Moumou, 65 years old, admitted to hospital for “abdominal discomfort for 6 months with abdominal cleat pain 1d.” Physical examination: weight loss, acute painful face, normal heart and lung, abdomen bulge, bloating tension, abdominal tenderness and rebound tenderness, mainly Mai Mai point, disappearance of liver dullness, perforation and laparotomy, see ileocecal 6cm×6cm ulcer type masses, among which there is a 3cm×3cm perforation, 40, 50 and 70cm from the ileocecal, and another 5cm×5cm, 5cm×4cm, 3cm×4cm ulcerative mass, and adhesion to the back. Blind, right colon and some small bowel resection, anastomotic leakage occurred in the second week after operation, pathological diagnosis, colon non-Hodgkin’s disease. One month after the death. Example 2: Male, Yang Moumou, 40 years old, admitted to hospital because of “the pain in the right lower abdomen for 4 days, intensified for 1 day”, accompanied by mucus bloody stools once. Physical examination: weight loss, acute pain appearance, right lower abdominal muscle tension, tenderness and rebound tenderness in the left lower abdomen, untouched mass, presence of liver dullness; acute appendicitis and perforation caesarean section. The ileocecal section of the investigation revealed a huge ulcer of 5cm × 6cm, pale surface, soft texture, including a 5cm × 2cm perforation and right colon resection, exploration specimens: marked hard, but soft, pale, ulcers There is no obvious boundary with normal bowel pathology: non-Hodgkin’s lymphoma, T cell source, diffuse type. Lymphoid cells were not found in the lymph nodes. On the 10th day after operation, malignant tissue cells were found in the bone marrow phase and blood phase. One month after surgery, multiple organs died due to hyperthermia. Example 3: Male, He Moumou, 43 years old, admitted to hospital because of “intermittent pain in the right abdomen for six months and low fever for one month”. Admission to the hospital for barium enema shows colonic space-occupying lesions, after irrigation?