【摘要】 目的探讨原发性小肠淋巴瘤(PSIL)的临床表现、内镜下特点和影像学特征。方法收集2010—2017年在复旦大学附属华山医院诊断和治疗的20例PSIL患者的病史资料,回顾性分析其临床、内镜和影像学资料。结果 20例患者的主要症状为消化道出血、腹痛和腹部不适、纳差、消瘦、腹泻、发热。行双气囊小肠镜检查15例,均发现小肠占位性病变,13例经活组织病理学检查确诊;行胶囊内镜检查9例,7例发现病灶。18例发现病灶者的内镜下表现为结节/息肉样增生型8例,溃疡型2例,肿块型2例,弥漫浸润型1例,混合型5例。病灶位于回肠11个,空肠6个,十二指肠4个。10例患者消化道多部位受累。病理类型均为非霍奇金型淋巴瘤,以黏膜相关淋巴组织(MALT)淋巴瘤最多。结论 PSIL的临床表现多不典型,回肠发病率最高,内镜下分型以结节/息肉样增生型多见,胶囊内镜和小肠镜为发现小肠淋巴瘤病灶的主要手段,非手术确诊有赖于小肠镜下活组织检查。更多还原

【Abstract】 Objective To investigate clinical manifestations,endoscopic and imaging features of primary small intestinal lymphoma(PSIL).Methods Clinical,endoscopic and imaging data of 20 PSIL patients treated in Shanghai Huashan Hospital between 2010 and 2017 were analyzed retrospectively.Results Gastrointestinal bleeding,abdominal pain,abdominal discomfort,anorexia,weight loss,diarrhea and fever were the most commonest clinical manifestations in these patients.Space occupying lesions were found in 15 patients who underwent double-balloon endoscopy(DBE)and confirmed by biopsy in 13 of them.Capsule endoscopy(CE)was performed in nine patients and lesions were found in seven of them.There were eight patients with nodular/polypoid hyperplasia,two with ulcerative lesions,two with mass-forming,one with diffuse infiltration,and five with mixed lesions.Lesions of 11 cases were only found in ileum,six in jejunum,and four in duodenum.Multifocal lesions were found in 10 cases.Pathological types were non Hodgkin lymphoma in all the patients,mostly mucosalassociated lymphoid tissue(MALT)lymphoma.Conclusions There is atypical clinical manifestation in most PSIL.The highest incidence is found in the ileum.Most present nodular/polypoid hyperplasia under endoscope.The diagnosis mostly relies on CE and DBE.Tissue biopsy under DBE can confirm the disease更多还原