Al-Taie O, Dietrich C G, Flieger D, Katzenberger T, Fischbach W
Department of Internal Medicine, Sankt Elisabeth Hospital, Guetersloh, Germany.
Z Gastroenterol. 2013 Aug;51(8):727-32. doi: 10.1055/s-0033-1335077. Epub 2013 Aug 16.
In earlier studies, involvement of the small intestine was reported in patients with gastrointestinal lymphoma. Prospective data on the involvement of the small intestine in patients suffering from gastric extranodal MZBCL of MALT do not exist so far. In this study, we investigated the frequency of the involvement of the small intestine and the role of capsule endoscopy in patients with gastrointestinal extranodal MZBCL of MALT and of follicular lymphoma.
40 consecutive patients with gastrointestinal extranodal MZBCL of MALT (26 men, 14 women, aged 27 - 80 years), and 7 patients with known follicular lymphoma of the small intestine (5 men, 2 women, aged 34 - 63 years) underwent capsule endoscopy.
Involvement of the small intestine was identified by capsule endoscopy in all 7 patients with known follicular lymphoma of the small intestine. In 6 of 40 patients with gastric extranodal MZBCL of MALT abnormal findings could be observed, three of these findings indicative for lymphoma involvement of the small intestine. However, in each of these 3 cases, intestinal involvement had been already diagnosed by conventional GI endoscopy before capsule endoscopy.
Capsule endoscopy is able to detect involvement of the small intestine in patients with gastrointestinal lymphoma. However, involvement of the small intestine seems to be rare in patients with gastric extranodal MZBCL of MALT. In summary, routine diagnostic work-up of the small intestine, e. g. by capsule endoscopy seems unnecessary because of the rare involvement of the small intestine and an excellent long-term outcome irrespective of a possible intestinal manifestation.
在早期研究中，有报道称胃肠道淋巴瘤患者存在小肠受累情况。目前尚无关于胃黏膜相关淋巴组织（MALT）结外边缘区B细胞淋巴瘤（MZBCL）患者小肠受累的前瞻性数据。在本研究中，我们调查了胃肠道MALT结外MZBCL及滤泡性淋巴瘤患者小肠受累的频率以及胶囊内镜在其中的作用。
40例连续性胃肠道MALT结外MZBCL患者（男26例，女14例，年龄27 - 80岁）以及7例已知小肠滤泡性淋巴瘤患者（男5例，女2例，年龄34 - 63岁）接受了胶囊内镜检查。
在所有7例已知小肠滤泡性淋巴瘤患者中，通过胶囊内镜均发现小肠受累。在40例胃MALT结外MZBCL患者中，6例观察到异常发现，其中3例提示小肠有淋巴瘤累及。然而，在这3例中的每一例中，小肠受累在胶囊内镜检查前已通过传统胃肠内镜诊断。
胶囊内镜能够检测出胃肠道淋巴瘤患者的小肠受累情况。然而，胃MALT结外MZBCL患者的小肠受累似乎很少见。总之，由于小肠受累罕见且无论有无可能的肠道表现都有良好的长期预后，常规对小肠进行诊断性检查，如通过胶囊内镜检查似乎没有必要。
