Laws H L, Han S Y, Aldrete J S
South Med J. 1984 Sep;77(9):1087-90. doi: 10.1097/00007611-198409000-00007.
The four common types of small bowel malignancies have different clinical presentations, routes of metastatic spread, and prognoses, and may require selective treatment. A review of our experience over a 16-year period revealed 45 cases: 16 adenocarcinomas, 13 carcinoids, nine leiomyosarcomas, five lymphomas, and two fibrosarcomas. Adenocarcinomas tend to occur in the upper part of the small intestine, cause obstruction and occult blood loss, and metastasize to the regional nodes and liver. Carcinoids generally begin in the distal portion of the small bowel, may form rather large metastatic masses and cause obstruction from a metastatic mass or intussusception, and are often multiple. Leiomyosarcomas develop in any part of the bowel, may present a primary mass, gross hemorrhage, or perforation, and have blood-borne metastases. Lymphomas tend to occur in the distal part of the small bowel, with pain or mass formation, and spread via the lymphatics. Critical analysis of the clinical presentation and findings should allow preoperative recognition of the specific pathologic type.
四种常见的小肠恶性肿瘤具有不同的临床表现、转移途径和预后，可能需要进行选择性治疗。回顾我们16年间的经验，共发现45例病例：16例腺癌、13例类癌、9例平滑肌肉瘤、5例淋巴瘤和2例纤维肉瘤。腺癌倾向于发生在小肠上部，可导致梗阻和潜血，转移至区域淋巴结和肝脏。类癌通常起源于小肠远端，可形成较大的转移肿块，并因转移肿块或肠套叠导致梗阻，且常为多发。平滑肌肉瘤可发生于肠道的任何部位，可出现原发性肿块、大出血或穿孔，并经血行转移。淋巴瘤倾向于发生在小肠远端，伴有疼痛或肿块形成，并通过淋巴管扩散。对临床表现和检查结果进行批判性分析应能在术前识别特定的病理类型。
