肺原发性黏膜相关B细胞性恶性淋巴瘤1例并文献复习

Pulmonary Primary Small B-Cell Lymphoma of Mucosa-Associated with Lymphoid Tissues:A Case Report and Review of Literature

目的研究肺原发性黏膜相关B细胞性恶性淋巴瘤(MALToma)的临床病理特征及鉴别诊断要点。方法采用HE染色和免疫组化标记对1例肺MALToma进行临床病理学分析。结果显微镜观察幼稚淋巴细胞弥漫性或结节性增生,有的结节中可见萎缩的生发中心。部分区域细胞排列成片状,细胞大小一致,血管较丰富,形似类癌。免疫组化:LCA局灶(+)、CD45RO、CD5散在(+),CD45RA、CD20广泛(+),NSE、CK、Syn均(-)。结论肺原发性MALToma是一种少见的低度恶性肿瘤,原发于双肺的更为少见,本例缺乏淋巴上皮病变,组织学形态结构复杂,极易误诊。因此,早期诊断对预后关系重大。

Objective To investigate the clinicopathologic features and differential diagnoses of pulmonary primary small B-cell Lymphoma of mucosaassociated with lymphoid tissues.Methods The clinical and pathological features of 1 case with pulmonary primary small B-cell lymphoma of mucosa-associated with lymphoid tissues were evaluated by light microscopy and immunohistochemistry. Results Diffused and nodular hyperplasia of prolymphocyte could be observed in some areas. The tumor cells were of the similar size and arranged in sheet in some areas. There were many blood vessels in such areas. It looked like carcinoid tumor. LCA was locally expressed. CIMSRO and CD5 were found to be scattered positive. CD45RA and CD20 were found to be diffuse positive. There were no expressions of NSE,CK and Syn. Conclusions Pulmonary primary lymphoma of mucosa-associated with lymphoid tissues is a rare low-grade malignant tumor ,bilateral lesion is very rare. It can be easily misdiagnosed because of lack of lymphoepithelial lesion and complicated histological features. Early diagnosis of this tumor plays an important role in the patient＇ s prognosis.