原发性小肠恶性肿瘤的临床误诊分析

目的 分析原发性小肠恶性肿瘤的临床病理特征及其误诊原因。方法 回顾性分析近21年收治并经病理证实的90例原发性小肠恶性肿瘤的临床资料。结果 病理类型以腺癌、平滑肌肉瘤、恶性淋巴瘤、恶性神经鞘膜瘤为主。主要临床表现为腹痛、出血、贫血、腹块、黄疸、消瘦、肠梗阻等。术前诊断符合率22．2％。术前误诊率为77．8％，多误诊为其他肖化系统疾病及盆腔疾病。结论 原发性小肠恶性肿瘤以腺癌、平滑肌肉瘤、恶性淋巴瘤、恶性神经鞘膜瘤为多见。临床表现缺乏特异性，检查手段相对不足，易导致延误诊断，临床医生应提高对小肠恶性肿瘤的认识。

Misdiagnosis of primary malignant tumor in small intestine

Objective To investigate the clinical manifestations, histopathological patterns and causes of misdiagnosis of primary malignant tumor in small intestine (PMTSI). Methods The clinical data of 90 cases of PMTSI confirmed by pathology admitted from 1981 to 2002 in our hospital were retrospectively analyzed. Results The main pathological patterns of PMTSI were adenocarcinoma, leiomyosarcoma, lymphoma and malignant neurilemmoma. The common clinical manifestations were abdominal pain, anemia and hemorrhage, jaundice, weight loss and intestinal obstructions. Preoperative diagnosis rate was 22.2%(20/90). It was easily misdiagnosed as other digestive tract diseases and pelvic disorders. Preoperative misdiagnosis rate was 77.8%. Conclusions The main pathological patterns of PMTSI are adenocarcinoma, leiomyosarcoma, lymphoma and malignant neurilemmoma.Its clinical manifestations and diagnostic examination methods are not good enough, which usually leads to misdiagnosis ,so attention must be paid.