The diagnosis of primary small intestinal lymphoma (PSIL) is difficult. This study aimed to evaluate the clinical, radiological and endoscopic characteristics of PSIL and provide clue for diagnosis. A total of 30 patients diagnosed with PSIL who underwent double balloon endoscopy (DBE) in the First Affiliated Hospital of Zhejiang University were retrospectively analyzed. Clinical, radiological and endoscopic data were collected. Univariate analysis was used to determine significant indicators for differentiating three main subtypes of PSIL. Cox regression analysis was performed to assess the risk factors for survival. In this study, 10 patients were pathologically diagnosed as diffuse large B-cell lymphoma (DLBCL), 11 were indolent B-cell lymphoma (BCL) and 9 were T-cell lymphoma (TCL). Compared with DLBCL patients, the body mass index (BMI) of TCL patients was significantly lower (p = 0.004). Meanwhile, compared with patients with DLBCL, the patients with indolent BCL had lower levels of C-reactive protein, lactate dehydrogenase (LDH), fibrinogen and D-Dimer (p = 0.004, p = 0.004, p = 0.006, and p = 0.002, respectively), and lower proportion of thicker intestinal wall and aneurysmal dilation in CT scan (p = 0.003 and p = 0.020, respectively). In terms of ulcer morphology, patients with DLBCL had significantly higher proportion of deep ulcers than patients with indolent BCL (p = 0.020, respectively). Cox regression analysis showed that drink (p = 0.034), concomitant colonic ulcers (p = 0.034) and elevated LDH (p = 0.043) are risk factors for mortality in patients with PSIL. This study provides clinical characteristics of patients with PSIL. Thicker intestinal wall and aneurismal dilation detected on CT scan and deeper ulcer on DBE examination helps to establish a diagnosis of DLBCL.

中文翻译：

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原发性小肠淋巴瘤的特征：基于双气囊内镜的回顾性研究

原发性小肠淋巴瘤（PSIL）的诊断很困难。本研究旨在评估PSIL的临床、影像学和内镜特征，为诊断提供线索。回顾性分析浙江大学第一附属医院收治的30例确诊为PSIL并接受双球囊内镜检查（DBE）的患者。收集临床、放射学和内窥镜数据。使用单变量分析来确定区分 PSIL 三种主要亚型的显着指标。进行 Cox 回归分析以评估生存的危险因素。本研究中，10例患者经病理诊断为弥漫性大B细胞淋巴瘤（DLBCL），11例为惰性B细胞淋巴瘤（BCL），9例为T细胞淋巴瘤（TCL）。与DLBCL患者相比，TCL患者的体重指数（BMI）显着较低（p = 0.004）。同时，与DLBCL患者相比，惰性BCL患者的C反应蛋白、乳酸脱氢酶（LDH）、纤维蛋白原和D-二聚体水平较低（p = 0.004、p = 0.004、p = 0.006和p = 0.002） ，分别），并且 CT 扫描中较厚的肠壁和动脉瘤扩张的比例较低（分别为 p = 0.003 和 p = 0.020）。就溃疡形态而言，DLBCL 患者的深层溃疡比例显着高于惰性 BCL 患者（p = 0.020）。Cox回归分析显示，饮酒（p = 0.034）、伴随结肠溃疡（p = 0.034）和LDH升高（p = 0.043）是PSIL患者死亡的危险因素。本研究提供了 PSIL 患者的临床特征。CT扫描发现较厚的肠壁和动脉瘤扩张以及DBE检查发现较深的溃疡有助于DLBCL的诊断。