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目的:探讨影像学检查及胃镜、超声内镜对原发性胃淋巴瘤的术前诊断方法,以提高该疾病的术前诊断率。方法:总结我院经手术及病理证实的21例原发性胃淋巴瘤资料,评估胃镜活检、超声内镜及CT对该病诊断的作用。结果:21例术前CT检查,误诊为浸润型胃癌11例,间质瘤2例,未见明显异常3例。CT术前诊断率为23.8%(5/21)。全部患者均实施胃镜检查,活检病理诊断淋巴瘤14例,胃镜活检诊断率为66.7%(14/21)。其中10名患者实施超声胃镜检查,判断胃淋巴瘤6例、胃癌3例、间质瘤1例;术前诊断率为60.0%(6/10)。结论:胃镜及超声内镜是原发性胃淋巴瘤的主要术前诊断方式;CT扫描能明确有无纵隔及腹腔内淋巴结肿大,为原发性胃淋巴瘤提供诊断依据。
OBJECTIVE: To explore the preoperative diagnosis of primary gastric lymphoma by imaging examination, endoscopy and endoscopic ultrasonography to improve the preoperative diagnosis rate of this disease. Methods: The data of 21 cases of primary gastric lymphoma confirmed by operation and pathology in our hospital were summarized. The effects of endoscopy, endoscopic ultrasonography and CT on the diagnosis of the disease were evaluated. Results: 21 cases of preoperative CT examination, misdiagnosed as invasive gastric cancer in 11 cases, stromal tumor in 2 cases, no obvious abnormalities in 3 cases. The preoperative diagnosis rate of CT was 23.8% (5/21). All patients underwent endoscopy, biopsy diagnosis of lymphoma in 14 cases, the diagnosis of gastroscopy biopsy was 66.7% (14/21). Ultrasound gastroscopy was performed in 10 of them. Six cases of gastric lymphoma, three cases of gastric cancer and one case of stromal tumor were diagnosed. The preoperative diagnosis rate was 60.0% (6/10). Conclusion: Gastroscopy and endoscopic ultrasonography are the main preoperative diagnosis of primary gastric lymphoma. CT scan can determine the presence of mediastinal and intra-abdominal lymph nodes and provide a diagnostic basis for primary gastric lymphoma.