Primär intestinale Lymphome — Diagnosestellung mittels CT und Therapie

Holger Gößmann , Thomas Görlitz , Andreas Beck , Hans-Bernd Reith
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Abstract

Primary intestinal lymphomas are most common in the stomach. The mucosa associated lymphatic tissue (MALT)-lymphoma which is closely associated with helicobacter pylori is very well known. In most cases, these malignancies are from B-Cells origin. Another possible point of manifestation, although not well known, is the small bowel. Both tumors have enormous capabilities to enlarge in the abdominal cave. This is responding to their often asymptomatic manifestation. The symptoms, if they occur, are widespread and unspecific. Ileus, diarrhae, abdominal pain or bleeding will be observed, in rare cases also perforation or gastrointestinal or cutaneous fistulas. Diagnostic imaging often demonstrates a tumour of massive size by then, which is echopoor in the abdominal ultrasound.

Our report concerns two cases of small intestine lymphomas, which were diagnosed by CT-scanning and treated in our clinic in only a short period of time. The first case was a low malignant jejunal lymphoma which was almost asymptomatic, whereas the second case had an ileus, due to compression of the intestine because of a high malignant lymphoma of the ileocecal region.

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通过CT和诊疗
原发性肠淋巴瘤最常见于胃。与幽门螺杆菌密切相关的粘膜相关淋巴组织淋巴瘤(MALT)是众所周知的。在大多数情况下,这些恶性肿瘤起源于b细胞。另一个可能的表现点,虽然不为人所知,是小肠。这两种肿瘤都有很大的能力在腹腔内扩大。这是对他们通常无症状表现的反应。这些症状,如果出现,是广泛的和不特定的。肠梗阻、腹泻、腹痛或出血将被观察到,在罕见的情况下也有穿孔或胃肠道或皮肤瘘管。诊断成像通常显示一个巨大的肿瘤,这是腹部超声的回声。我们的报告涉及两例小肠淋巴瘤病例,这两例病例是在很短的时间内通过ct扫描诊断并在我诊所治疗的。第一个病例是低恶性空肠淋巴瘤,几乎无症状,而第二个病例有肠梗阻,由于肠压迫,因为高恶性淋巴瘤的回盲区。
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