目的 探討胰腺淋巴瘤和胰腺癌的鑒別診斷及治療。
方法 回顧性分析我院2000年1月至2008年4月期間經(jīng)病理確診的5例胰腺淋巴瘤患者的臨床資料。
結(jié)果 本組5例患者臨床癥狀以腹痛、發(fā)熱、黃疸為主,除1例外血漿CA19-9均正常,臨床表現(xiàn)無法區(qū)分胰腺淋巴瘤和胰腺癌,CT等影像學(xué)有助于鑒別診斷。胰腺淋巴瘤CT增強(qiáng)掃描后均見強(qiáng)化表現(xiàn),胰管不粗,和周圍大血管關(guān)系緊密,鄰近血管結(jié)構(gòu)被推移,但無浸潤、包繞現(xiàn)象。治療以化療為主,除1例失訪外,其余4例分別存活24、14、14、13個月。
結(jié)論 胰腺淋巴瘤是一種罕見的疾病,臨床癥狀缺乏特異性,極易與胰腺癌混淆,治療和預(yù)后卻與胰腺癌不盡相同,臨床上應(yīng)該盡量通過CT或超聲下穿刺明確診斷,以避免不必要的手術(shù)。
引用本文: 黃中岳,費健,王建承,陳勝,吳衛(wèi)澤,韓天權(quán),彭承宏,張圣道. 胰腺淋巴瘤誤診為胰腺癌(附5例報道). 中國普外基礎(chǔ)與臨床雜志, 2009, 16(2): 150-151. doi: 復(fù)制
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5. | Jayanthi V, Randhir J, Rajesh N. Problems in diagnosing lymphoma of the pancreas with computed tomography: A case report [J]. J Gastrointestin Liver Dis, 2007; 16(1): 101. |
6. | Merkle EM, Bender GN, Brambs HJ. Imaging findings in pancreatic lymphoma: differential aspects [J]. AJR Am J Roentgenol, 2000; 174(3): 671. |
7. | Gleeson FC, Zhang L, Levy MJ, et al. Primary pancreatic lymphoma: endoscopic ultrasound-guided Trucut biopsy to the rescue [J]. Endoscopy, 2008; 40(Suppl 2): E23. |
8. | Islam S, Callery MP. Primary pancreatic lymphoma a diagnosis to remember [J]. Surgery,2001; 129(3): 380. |
9. | Lin H, Li SD, Hu XG, et al. Primary pancreatic lymphoma: report of six cases [J]. World J Gastroenterol, 2006; 12(31)∶5064. |
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- 1. Basu A, Patil N, Mohindra P, et al. Isolated non-Hodgkin’s lymphoma of the pancreas: case report and review of literature [J]. J Cancer Res Ther, 2007; 3(4): 236.
- 2. 胡亞, 杜瀟, 廖泉, 等.原發(fā)性胰腺淋巴瘤的診療分析 [J].中國普外基礎(chǔ)與臨床雜志, 2008; 15(4): 285.
- 3. Salvatore JR, Cooper B, Shah I, et al. Primary pancreatic lymphoma: a case report, literature review, and proposal for nomenclature [J]. Med Oncol, 2000; 17(3): 237.
- 4. Tuchek JM, De Jong SA, Pickleman J. Diagnosis, surgical intervention and prognosis of primary pancreatic lymphoma [J]. Am Surg, 1993; 59(8): 513.
- 5. Jayanthi V, Randhir J, Rajesh N. Problems in diagnosing lymphoma of the pancreas with computed tomography: A case report [J]. J Gastrointestin Liver Dis, 2007; 16(1): 101.
- 6. Merkle EM, Bender GN, Brambs HJ. Imaging findings in pancreatic lymphoma: differential aspects [J]. AJR Am J Roentgenol, 2000; 174(3): 671.
- 7. Gleeson FC, Zhang L, Levy MJ, et al. Primary pancreatic lymphoma: endoscopic ultrasound-guided Trucut biopsy to the rescue [J]. Endoscopy, 2008; 40(Suppl 2): E23.
- 8. Islam S, Callery MP. Primary pancreatic lymphoma a diagnosis to remember [J]. Surgery,2001; 129(3): 380.
- 9. Lin H, Li SD, Hu XG, et al. Primary pancreatic lymphoma: report of six cases [J]. World J Gastroenterol, 2006; 12(31)∶5064.
- 10. 何天霖, 胡先貴, 劉瑞, 等.原發(fā)性胰腺淋巴瘤的診斷和治療(附9例報告)[J]. 第二軍醫(yī)大學(xué)學(xué)報, 2005; 26(8): 875.
- 11. Grimison PS, Chin MT, Harrison ML, et al. Primary pancreatic lymphoma-pancreatic tumours that are potentially curable without resection, a retrospective review of four cases [J]. BMC Cancer, 2006; 6(5): 117.