目的 提高对成人系统性Epstein-Barr（EB）病毒阳性T细胞淋巴组织增殖性疾病（ASEBV+T-LPD）肠道病变的认识。 方法 报道2012年3月－10月我院收治的2例以肠道病变为首发表现的ASEBV+T-LPD，并结合3例文献报道进行分析讨论。 结果 2例成人患者以腹泻为主要表现，伴有发热、淋巴结长大，初期分别误诊为结核及肠道感染，淋巴结病检提示多克隆EBER+的T淋巴细胞浸润，确诊ASEBV+T-LPD。例1经3 周期GLIDE方案（吉西他滨+门冬酰胺酶+异环磷酰胺+地塞米松+依托泊苷）化学疗法（化疗）后疾病进展，死于肺部感染。例2经干扰素联合抗病毒药物治疗，病情稳定。复习文献目前仅3例以肠道病变为首发表现的ASEBV+T-LPD被报道，早期均被误诊为炎性肠病或感染，3例均出现肠道穿孔或大出血等并发症，其中2例死亡。 结论 成人系统性EB病毒阳性T细胞淋巴组织增殖性疾病的肠道病变较为罕见，容易误诊为结核及炎性肠病。部分患者病情进展迅速，可出现肠道穿孔及消化道大出血等致死性并发症，死亡率高，预后差。确诊本病需密切结合临床和病理学检查。常规化疗及抗病毒治疗仅部分有效，不能维持长期缓解。
ObjectiveTo conclude the effect of surgery in the treatment of primary gastrointestinal lymphoma (PGIL) and provide evidence in subsequent studies and treatments in PGIL.MethodThe relevant literatures at home and abroad in recent years about the role of surgery in the treatment of PGIL were reviewed.ResultsCommon clinical strategies included surgery, chemotherapy, radiotherapy, and so on. Due to the low incidence, there were few large sample, multi-center, and prospective studies. The surgery was beneficial on relieving the potential risk of complications such as bleeding, perforation, and obstruction. In addition, the surgery provided easy access for direct observation and biopsy. Furthermore, specific pathological stage was necessary for subsequent therapy. For certain PGIL, the indications of surgery became increasingly clear. But it was controversial about treatment strategy of PGIL, especially the effect of surgery.ConclusionThe treatment strategy should be individualized according to the lesion site, pathological type, and clinical stage.