探讨肝原发性黏膜相关淋巴组织淋巴瘤的病理学特征

Pathologic features of primary hepatic mucosa-associated lymphoid tissue (MALT) Lymphoma

目的探讨肝原发性黏膜相关淋巴组织(MALT)淋巴瘤的临床病理特征、免疫表型和基因重排特点。方法对2例原发于肝黏膜相关淋巴组织淋巴瘤进行回顾性研究,包括临床病理观察、免疫组化检测及多聚酶链反应(PCR)检测基因重排。结果2例均为偶然发现肝占位性病变,肿瘤组织主要由中心细胞样B细胞和单核细胞样B细胞构成,均见肿瘤细胞侵犯胆管上皮、侵袭肝细胞索形成淋巴上皮病变,肿瘤细胞CD20、CD79α和Pax-5(+),T细胞标记(-),IgH基因均呈单克隆重排。结论原发性肝MALT型淋巴瘤是一种惰性淋巴瘤,多为偶然发现的肝占位性病变,诊断及鉴别诊断需要结合病理形态、免疫组化标记及必要的基因重排检测。

Objective To study the clinicopathologic and features and gene rearrangement of primary hepatic mucosa-associated lymphoid tissue （MALT） lymphoma. Methods 2 cases of primary hepatic MALT lymphoma were studied by the clincopathologic observation, immunohistochemical staining and PCR gene rearrangement analysis Results 2 tumors were found incidentally by physical examimation. The tumor cells were composed of centrocyte-like cells and monocyte-like cells. The tumor cells invaded biliary duct and hepatic cords to form typical lymphoepithelial lesions. The tumor cells were positive for CD20, CD79α, Pax-5 but negative for T cell markers. IgH gene rearrangement was found in 2 cases. Conclusion Primary hepatic MALT lymphoma is an indolent lymphoma, which is always found incidentally. Clinicopathologic, immunohistocl and gene rearrangement analysis will be useful in the diagnosis and differential diagnosis of this primary hepatic lymphoma.