小结
定义
病史和体格检查
Key diagnostic factors
- 幽门螺杆菌胃炎病史
- 自身免疫性疾病史
- 年龄 60 岁以上
- 消化不良
- 上腹不适
- 皮肤病变
- 红眼 ± 畏光
- 无痛眼球突出、复视、眼睛能动性障碍、下垂症、视力下降。
Other diagnostic factors
- 恶心和/或呕吐
- 消化道出血
- 发热
- 盗汗
- 体重减轻
- 呼吸困难、咯血、咳嗽
- 唾液腺肿大
- 甲状腺肿
- 乳房肿块
- 局灶神经系统功能障碍
- 淋巴结肿大
Risk factors
- 幽门螺杆菌感染
- 年龄 60 岁以上
- 自身免疫性疾病
- 女性
- 鹦鹉热衣原体感染
- 空肠弯曲菌感染
- 伯氏疏螺旋体感染
- 丙型肝炎病毒感染
- 艾滋病病毒 (HIV) 感染
Diagnostic tests
1st tests to order
- 全血细胞计数 (FBC)
- 血涂片
- 上消化道内镜检查
- 受累组织活检
- 分期 CT 扫描
- 幽门螺杆菌血清学检测
- 幽门螺杆菌粪便抗原检测
- 肝功能检查 (LFT)
- 基础代谢检查
Tests to consider
- 骨髓活组织检查
- 免疫组织化学检查
- 逆转录聚合酶链反应 (RT-PCR) 或荧光原位杂交 (FISH) 试验
- 免疫球蛋白基因重排研究
- 血清电泳
- 血清乳酸脱氢酶
- 血清 β-2 微球蛋白
- 18 氟-氟代脱氧葡萄糖(FDG)PET/CT 扫描
- 胃部内镜超声
- 胃肠道双重对比造影检查
- 下消化道内镜检查
- 耳鼻喉内窥镜检查
- 唾液腺的 CT 扫描
- 眼眶 MRI
- 丙型肝炎血清学检查
- 乙型肝炎血清学检查
- HIV 血清学
- 放射性核素多门电路心血池显像(MUGA)
- 超声心动图
- 乙二胺四乙酸肾小球滤过率 (EDTA GFR)
Treatment algorithm
低度局部胃部:幽门螺杆菌阳性
低度局部胃部:幽门螺杆菌阴性
低度恶性晚期胃部
低度恶性非胃部
高度恶性的组织学类型转变:胃部或非胃部
Contributors
Authors
Christopher McNamara, MBBS (Hons), FRACP, FRCPA, FRCPath
Consultant Haematologist
Royal Free Hospital
London
UK
Disclosures
CM declares that he has no competing interests.
Acknowledgements
Dr Christopher McNamara wishes to gratefully acknowledge Dr Rahul Joshi, a previous contributor to this topic. RJ declared that he had no competing interests. Unfortunately, we have since been made aware that Dr Rahul Joshi is deceased.
Peer reviewers
Markus Raderer, MD
Professor of Medicine
Department of Internal Medicine I
Division of Oncology
Medical University Vienna
Austria
Disclosures
MR is an author of a number of references cited in this topic.
Alan Lichtin, MD
Staff Hematologist
Cleveland Clinic Taussig Cancer Center
Cleveland
OH
Disclosures
AL declares that he has no competing interests.
Ian Chau, MD
Consultant Medical Oncologist
Royal Marsden Hospital
Sutton
UK
Disclosures
IC has been reimbursed by Roche Products, the manufacturer of rituximab, for attending several conferences. IC has also served on advisory boards and received honorarium for giving presentations for Roche Products. IC has received research funding from Novartis to conduct academic studies in the treatment of colorectal cancer.
Differentials
- 套细胞淋巴瘤
- 小淋巴细胞性淋巴瘤
- 滤泡性淋巴瘤
More DifferentialsGuidelines
- NCCN 肿瘤学临床实践指南:B 细胞淋巴瘤
- 边缘区淋巴瘤
More GuidelinesPatient information
非霍奇金淋巴瘤
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