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63例肠壁炎性假瘤的诊治分析[J]. 肿瘤防治研究, 2011, 38(12): 1415-1418. DOI: 10.3971/j.issn.1000-8578.2011.12.019
引用本文: 63例肠壁炎性假瘤的诊治分析[J]. 肿瘤防治研究, 2011, 38(12): 1415-1418. DOI: 10.3971/j.issn.1000-8578.2011.12.019
Diagnosis and Treatment of Intestinal Inflammatory Pseudotumor(63 Cases Attached)[J]. Cancer Research on Prevention and Treatment, 2011, 38(12): 1415-1418. DOI: 10.3971/j.issn.1000-8578.2011.12.019
Citation: Diagnosis and Treatment of Intestinal Inflammatory Pseudotumor(63 Cases Attached)[J]. Cancer Research on Prevention and Treatment, 2011, 38(12): 1415-1418. DOI: 10.3971/j.issn.1000-8578.2011.12.019

63例肠壁炎性假瘤的诊治分析

Diagnosis and Treatment of Intestinal Inflammatory Pseudotumor(63 Cases Attached)

  • 摘要: 目的 探讨肠壁炎性假瘤(intestinal inflammatory pseudotumor,IIP)的临床、病理、诊断与治疗。方法 收集共63例IIP(本院2例,文献报道61例)的临床资料,分析和总结其主要临床表现、影象学检查、内镜检查、病理学诊断依据及治疗方法与疗效。结果IIP常发生于成年人,以男性多见,大部分以腹痛、腹部包块为主要症状,常伴有发热,无明显贫血,影象学检查示绝大部分为单发包块(93.7%,59/63),B型超声、CT检查示腹部实性或囊实性肿块,有钙化,本院2例CT增强扫描肿块呈中度强化,强化不均匀,且进行性强化,延迟增强。钡灌肠显示肠腔不规则或圆形充盈缺损,肠腔狭窄,钡剂可通过,边缘光滑,黏膜完整无破坏,肠镜检查大部分肿物向肠腔内突出,肠黏膜完整(71.4%,20/28),部分为溃疡型肿块,病理为肠黏膜中——重度慢性炎症;镜检可见增生的梭形细胞及浸润的慢性炎细胞包括淋巴细胞、浆细胞及胶原纤维形成,多种成分相互混杂,免疫组织化学Vimentin、SMA、MSA等表达阳性;63例均行手术切除,随访3月~4年,无复发与转移。结论IIP是较罕见的间叶性肿瘤,临床表现及影象学检查、内镜检查无特征性,综合分析临床、检查,有一定特点,术前易误诊为恶性肿瘤,依靠病理学检查和免疫组织化学检测确诊,手术切除是有效的治疗方法,预后良好。

     

    Abstract: Objective To investigate the clinicopathologic characteristics、diagnosis and treatment of intestinal inflammatory pseudotumor(IIP). Methods Clinical data of 63 cases with IIP were collected in which 2 cases treated in Guangzhou General Hospital of Guangzhou Military Command and other 61cases reviewed from literature reported sporadically in recent years.Clinical manifestations,imageology examination, endoscope examination,pathologic diagnosis,therapeutic method and effect were analyzed and summarized. Results IIP occurs most often in adults,more common in men.The main symptoms is abdominal pain and tumor,often accompany fever,but no anemia.Most mass are solitary localized displayed in imageology examination (93.7%,59/63).Abdominal sacculated or solid mass was detected by B-ultrasonography,accompanying calcification.Two cases in our hospital display medium enhancement,asymmetrical,progressive,tardive in masses by CT.Barium enema showed enteric cavity irregularity or circular filling-defect and narrow but barium can pass through,accompanying smoothed margin and intact mucosa.Enteroscopy examination showed a majority of masses growth protrudent in intestines and intact mucosa(71.4%,20/28),mucosa moderate and severe chronic inflammatory in pathology,and partial is ulcer mass. Pathological examination: Hyperplasia of spindle cells and chronic inflammatory cells, include lymphocytes,plasma cells,collagen fibrils,were observed by microscope.Immunohistochemistry showed positive expression in Vimentin,SMA,MSA; 63 patients all underwent operation.There were no relapses or metastases during three months to four years follow-up after operation. Conclusion IIP is a rare mesenchymal tumor without clinical characteristic. Imageology and endoscopic checks don′t show characteristics.But IIP has certain characteristics after synthetic analysis.It is easy to misdiagnosed as malignant tumors before surgery.Accurate diagnosis rely on immunohistochemistry and pathological examination.The effective treatment to IIP is operation, which has a good prognosis.

     

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