肠道非B细胞淋巴瘤与克罗恩病的鉴别诊断

吕春亮; 杨丽; 林辉; 王光宪; 唐雪峰; 郭红

doi:10.16016/j.1000-5404.201812069

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肠道非B细胞淋巴瘤与克罗恩病的鉴别诊断

临床医学 | 更新时间：2026-01-09

- 肠道非B细胞淋巴瘤与克罗恩病的鉴别诊断
- Differential diagnosis of intestinal non-B cell lymphoma and Crohn's disease
- 第三军医大学学报 2019年41卷第6期页码：618-623
- 作者机构：
  
  1.400037 重庆，陆军军医大学(第三军医大学)第二附属医院：消化内科
  2.400037 重庆，陆军军医大学(第三军医大学)第二附属医院：放射科
  3.0037 重庆，陆军军医大学(第三军医大学)第二附属医院消化内科：病理科
- 作者简介：
  
  [ 郭红, E-mail: hguoxqyy@163.comGUO Hong, E-mail: hguoxqyy@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.201812069
  中图分类号： R447;R574;R735.3
- 收稿：2018-12-06，
  
  修回：2019-01-27，
  
  纸质出版：2019-03-30
- 稿件说明：
移动端阅览
吕春亮, 杨丽, 林辉, 等. 肠道非B细胞淋巴瘤与克罗恩病的鉴别诊断[J]. 第三军医大学学报, 2019,41(6):618-623.

Chunliang LYU, Li YANG, Hui LIN, et al. Differential diagnosis of intestinal non-B cell lymphoma and Crohn's disease[J]. Journal of Third Military Medical University, 2019, 41(6): 618-623.
吕春亮, 杨丽, 林辉, 等. 肠道非B细胞淋巴瘤与克罗恩病的鉴别诊断[J]. 第三军医大学学报, 2019,41(6):618-623. DOI： 10.16016/j.1000-5404.201812069.

Chunliang LYU, Li YANG, Hui LIN, et al. Differential diagnosis of intestinal non-B cell lymphoma and Crohn's disease[J]. Journal of Third Military Medical University, 2019, 41(6): 618-623. DOI： 10.16016/j.1000-5404.201812069.

摘要

目的

探讨克罗恩病(Crohn’s disease

CD)和肠道非B细胞淋巴瘤的临床鉴别诊断特点。

方法

回顾性分析我院2012年1月至2018年8月收治的肠道非B细胞淋巴瘤(

=27)和CD病(

=30)患者的临床资料，寻找具有统计学意义的指标，并进一步分析其在鉴别诊断中的意义。

结果

腹腔脓肿、瘘管、肛周病变、肠外表现、阑尾切除病史在CD组中更常见，差异有统计学意义(

0.05)；B症状和急性肠穿孔在肠道非B细胞淋巴瘤组中更常见(

0.05)。血小板在CD组明显升高(

0.001)。内镜及小肠CT中，节段性病变、回盲部受累、肠腔狭窄、铺路石样改变，以及梳样征、息肉样凸起、系膜血管增生在CD组中更常见(

0.05)，腹腔淋巴结融合增大在肠道非B细胞淋巴瘤组中更为常见(

0.05)。

结论

临床需结合小肠CT、检验及内镜寻找CD和肠道非B细胞淋巴瘤的鉴别诊断点，从而提高确诊率。疑诊肠道非B细胞淋巴瘤者需多次内镜并多块深挖活检明确病理诊断。

Abstract

Objective

To investigate the clinical diagnostic characteristics of intestinal non-B cell lymphoma and Crohn's disease (CD).

Methods

The clinical data of 27 patients with intestinal non-B cell lymphoma and 30 CD patients admitted in our hospital from January 2012 to August 2018 were collected and retrospectively analyzed to search for the indexes with statistical significance and further analyze its significance in differential diagnosis.

Results

Abdominal abscess

fistula

perianal lesions

and intestinal stenosis were more common in the CD group (

0.05)

while

B symptoms and acute intestinal perforation were more common in lymphoma group (

0.05). The platelet count was significantly higher in the CD group than the lymphoma group (

0.001). In the endoscopic and intestinal CT images

segmental changes

ileocecal involvement

intestinal stenosis

cobblestone or paving stone-like changes

comb sign

polypoid bulge and Mesangial angiogenesis were more common in the CD group (

0.05)

while abdominal lymph node fusion was more common in intestinal lymphoma (

0.05).

Conclusion

In clinical practice

in order to improve the accuracy of diagnosis

it is necessary to find the differential diagnosis points of CD and intestinal non-B cell lymphoma by combining small intestinal CT scanning and endoscopy. For the patients suspected of lymphoma

multiple endoscopy and multiple deep-dug biopsies are needed to determine the pathological diagnosis.

关键词

Keywords

references

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