Analysis Of41Cases Primary Gastrointestinal Lymphomaclinical Features

Objective: To investigate the primary gastrointestinal lymphoma clinical features(PGIL) and improve the level of clinician in early diagnosis and effective treatment onthis disease, decreasing misdiagnose or missed diagnosis.Methods：Forty one patients hospitalized from2001to2011with primarygastrointestinal lymphoma,which are definitely diagnosed by pathologicalexamination with complete clinical data,were made a retrospective survey. Clinicalmanifestation, laboratory test, endoscopy, pathology typing, immunohistology andimaging examination, treatment measures and follow-up were all included.Results:1. General Information: All PGIL patients were examined by gastroscope orsurgery. There are twenty male patients and twenty one female patients,aged fromtwenty one to eighty four,average age is58.9±15.9. Location of tumor: thirty twocases in stomach, six cases in colon, three cases in small intestine.2. Clinical manifestations: The most common symptom is bellyache(85.4%,35/41),56.1%(23/41) inappetence,43.9%(18/41) weight loss,39%(16/41)anemia,39%(16/41) sour regurgitation、belching,29.3%(12/41) hematemesis、melena，7.3%(3/41) diarrhea and7.3%(3/41)fever. Physical signs：75.6%(31/41) withabdominal tenderness and36.6%(15/41) with abdominal mass.3. Laboratory examination: Twenty three cases had decreased protein (totalprotein、albumin)in different degrees by biochemistry test, twenty with increasedLDH,sixteen with decreased hemoglobin, three with abnormal tumor markers,(theyhad increased CEA mostly)、ten with increased AKP, seven with increased CRP, eight with OB test (+).4. Endoscopy：36patients were examined by gastroscope..2cases were suspectedlymphoma,32case were diagnosed cancer，1case was diagnosed inflammation andanother one was diagnosed Crohn’s disease.5.Computed tomography test: twenty one cases are examined by CT. Diffusegastrointestinal wall thickening and stenosis were found in twenty cases.2cases weresuspected lymphoma.6.Pathology typing and immunohistochemistry: According to the PGILpathological types proposed by WHO in2001, MALT:twenty cases (48.8%),DLBCL:eighteen cases(43.9%), PTCL: one case (2.4%),MCL: one case (2.4%)，MALT+DLBCL:one case(2.4%)； immunohistochemistry test shows CD20(+):92.7%（38/41）,CD79a(+):73.2﹪（30/41）, Ki-67﹪(+):34.1﹪,LCA(+):31.7﹪（13/41）.7. According to the improved standard of Ann Abor seventeen cases were in stageone, ten cases in stage two, six cases in stage three, eight cases in stage four.8.Treatment:1patient gave up treatment and23patients had operations.18.patients had chemotherapy after operation and16patients only hadchemotherapy without operation.1case in early MALT had simple HP eradicationtreatment.9. Follow-Up: Averaged follow-up duration were twenty months, while thirteencases withdrew. Six cases died within twelve months treatment, the rest patients arestill alive. Some of them continued to got chemotherapy.Conclusions:1.Gastrointestinal lymphoma patients have no specific manifestation.2.Iamging and endoscopy examination are still the main examination measure atpresent. The definitely diagnosis still needs pathological and immunohistochemistryexamination. That is the reasons for easily misdiagnosed or missed diagnosedclinically...