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成人肠套叠的不常见病因:弥漫性大 B 细胞非霍奇金淋巴瘤:病例报告及文献复习。

Unusual cause of adult intussusception: diffuse large B-cell non-Hodgkin's lymphoma: a case report and review.

机构信息

Department of Surgery, Diyarbakir Education and Research Hospital, Diyarbakir, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2012 Dec;16(14):1938-46.

Abstract

BACKGROUND

Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. A demonstrable etiology is found in 70% to 90% of cases in adult patients, and about 40% of them are caused by a primary or secondary malignant tumor. The aims of this study were to give an overview of the literature on intussusception due to gastrointestinal lymphoma.

MATERIALS AND METHODS

We present a case of ileocecal intussusception secondary to non-Hodgkin's lymphoma (NHL), as well as a literature review of studies published in the English language on intussusception secondary to lymphoma, accessed through PubMed and Google Scholar databases.

RESULTS

Thirty-six published cases of intussusception caused by lymphoma were evaluated, and a case of ileocecal lymphoma in a 62 year-old woman is herein presented. In the reviewed literature, 33 reports meeting the aforementioned criteria were included in this review. The patients were aged from 16 to 86 years (mean, 48.2 +/- 19.0 y). Twenty-nine were male and seven were female. According to the localization of lymphoma, 24 patients had ileo-colic intussusception, 10 had enteric, and 2 had colic intussusception. In terms of the diagnosis, 34 patients were diagnosed with various types of NHL, and two patients were diagnosed with HL.

CONCLUSIONS

Despite the rarity of intussusception cases secondary to malignant causes, particularly lymphoma, it is rather difficult to diagnose preoperatively by surgeons. Because there exists a risk of malignancy in a substantial portion of adult intussusception cases, resection should be performed in a manner consistent with the oncological principles.

摘要

背景

肠套叠是指一段肠道套入相邻的肠道。在成人患者中,70%至 90%的病例可发现明确病因,其中约 40%由原发性或继发性恶性肿瘤引起。本研究旨在综述胃肠道淋巴瘤引起的肠套叠文献。

材料和方法

我们报告了一例由非霍奇金淋巴瘤(NHL)引起的回盲肠套叠病例,并通过 PubMed 和 Google Scholar 数据库对发表的英文文献进行了回顾,以评估淋巴瘤继发肠套叠的研究。

结果

评估了 36 例由淋巴瘤引起的肠套叠病例,并报告了一例 62 岁女性回盲部淋巴瘤的病例。在综述的文献中,纳入了符合上述标准的 33 份报告。患者年龄从 16 岁至 86 岁(平均年龄 48.2±19.0 岁)。29 例为男性,7 例为女性。根据淋巴瘤的定位,24 例患者为回结肠肠套叠,10 例为肠套叠,2 例为结肠套叠。在诊断方面,34 例患者被诊断为各种类型的 NHL,2 例患者被诊断为 HL。

结论

尽管恶性原因,特别是淋巴瘤引起的肠套叠病例罕见,但外科医生在术前很难诊断。由于在相当一部分成人肠套叠病例中存在恶性肿瘤的风险,因此应根据肿瘤学原则进行切除。

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