兰州大学机构库 >学院待认领
原发性胃恶性淋巴瘤一例并文献复习
Alternative TitleOne case report of Primary Gastric Malignant Lymphoma and document review
麻瑞娟
Thesis Advisor吴静 ; 周永宁
2015-05-29
Degree Grantor兰州大学
Place of Conferral兰州
Degree Name硕士
Keyword原发性胃淋巴瘤 弥漫大B细胞性淋巴瘤 诊断 治疗
Abstract目的: 探讨原发性胃恶性淋巴瘤的临床表现、影像学检查、分类、发病机制、诊断要点和治疗方法,以提高本病的诊疗水平。方法: 分析1例原发性胃恶性淋巴瘤的临床资料,结合复习相关文献并总结。资料: 一老年女性患者,间断上腹部胀痛不适1月,入院前外院检查提示胃溃疡。我院门诊查电子胃镜提示:胃体溃疡性病变(Ca?)。病理活检提示:符合胃体溃疡。干预措施: 行各项常规检查及妇科和淋巴结超声、腹部增强CT、并多次行电子胃镜及病理活检等以明确诊断,同时予以抑酸、抗Hp、营养支持等对症治疗,经多次电子胃镜联合病理活组织检查后诊断明确,遂转入血液科给予FCR方案(R 500mg d0 + Fluda 30mg d1-3 + CTX 300mg d1-3)化学治疗,并密切观察病情、随访。结果: 电子胃镜示:胃淋巴瘤。病理活检示:弥漫大B细胞性淋巴瘤,生发中心来源,高度恶性。全腹增强CT示:1.胃壁局限性增厚轻度强化,符合胃淋巴瘤;2.肝胃间隙、腹膜后、肠系膜区、双侧髂血管旁多发肿大淋巴结;3.盆腔积液;左肾囊肿。最后诊断为非霍奇金淋巴瘤(胃原发) 弥漫大B细胞性淋巴瘤Ⅱ期 B组。结论: 原发性胃恶性淋巴瘤的临床表现缺乏特异性,依靠病理活检可确诊,但由于胃恶性淋巴瘤的病变常位于黏膜下淋巴组织,取活检存在一定困难,因此难以确诊,误诊率高。对内镜下表现考虑恶性病变的,取活检时需多次、多点、深取组织得以明确诊断,提高诊断率。
Other AbstractObjective: To investigate the clinical characteristics of Primary Gastric Malignant Lymphoma, imaging inspection, classification, pathogenesis, diagnostic essential and therapy programs etc. For the sake of raise the level of diagnosis and therapy of Primary Gastric Malignant Lymphoma. Methods: The clinical data of one patient suffered from Primary Gastric Malignant Lymphoma were retrospectively analyzed, and combined with related literature retrospect and summary.Data: An elderly women patient, who had intermittent abdominal pain and discomfort for more than one months. Prior to admission, in the other hospital gastroscopy examination revealed gastric ulcer. Our hospital outpatient examinations esophagogastroduodenoscopy showed gastric ulcer lesions (Ca?). Pathological biopsy showed: conform to the gastric ulcer. Interventions: To carry out the routine examination and chest X-ray, electrocardiogram, gynecological ultrasound, lymphonodus ultrasound, CT Scan- Abdomen, repeatedly electronic gastroscopy and pathological biopsy inspection, for purpose of acquirement of explicit diagnosis. Meanwhile, supportive therapy included acid suppression, Helicobacter pylori extirpation, nutritional support, and symptomatic therapy was used. After many times of gastroscopy and pathological biopsy inspection, the diagnosis was certificated, into the Department of Hematology to give chemotherapy scheme of FCR(R 500mg d0 + Fluda 30mg d1-3 + CTX 300mg d1-3), saving closely observe and follow.Results:Esophagogastroduodenoscopy showed: gastric lymphoma. Pathological examination of living tissue revealed: gastric lymphoma of diffuse large B cell, sources of the germinal center, highly malignant. Abdominal CT illustrated: 1.the lining of stomach local thickening saving mild reinforcement, conform to lymphoma of stomach; 2.the liver stomach clearance, retroperitoneal and mesenteric area, beside the bilateral iliac blood vessels and multiple lymph node enlargement; 3.pelvic effusion; the left kidney cyst. Finally, the patient was diagnosed as non-Hodgkin’s lymphoma (primary gastric) diffuse large B cell lymphoma II group B.Conclusion: The clinical characteristics of Primary Gastric Malignant Lymphoma lacks specificity. Primary Gastric Malignant Lymphoma can be confirmed with utilization pathological biopsy. But, due to lesions of gastric malignant lymphoma located in the submucosal lymphoid tissue, leading to take biopsy there exist certain difficulties. Thus, the existing c...
URL查看原文
Language中文
Document Type学位论文
Identifierhttps://ir.lzu.edu.cn/handle/262010/222277
Collection学院待认领
Affiliation临床医学院
Recommended Citation
GB/T 7714
麻瑞娟. 原发性胃恶性淋巴瘤一例并文献复习[D]. 兰州. 兰州大学,2015.
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