肺黏膜相关淋巴组织恶性淋巴瘤的细胞学、组织学及免疫组化对比研究

A comparative study of cytology,histopathology and immunohistochemistry of malignant lymphoma of lung mucosa-associated lymphoid tissues

目的:探讨肺黏膜相关淋巴组织恶性淋巴瘤(MALT-ML)细胞学、组织学及免疫组化特点及鉴别诊断要点。方法:对4例肺MALT-ML患者的穿刺组织及支气管镜刷检物进行细胞学、组织学及免疫组化对比分析。结果:4例肺MALT-ML患者中,细胞学诊断提示3例淋巴瘤,1例疑为小细胞未分化癌,MALT-ML不能排除;组织学提示4例患者为黏膜相关B细胞淋巴瘤;免疫表型瘤细胞CD20、CD79 a为阳性,CD3、CD5、CD10、CD45RO、Ckpan、EMA为阴性。结论:肺部MALT-ML极其少见,鉴别诊断十分困难。细针穿刺、支气管刷检细胞学、组织学及免疫组化标记技术等多种方法综合分析,可得出准确的结果。

Objective： To explore the cytopathologic features and differential diagnostic essentials of the lung mucosa-associated lymphoid tumor （MALT）. Methods： The fine needle aspiration （FNA） tissues and bronchi smears of 4 cases of MALT were examined by cytology, histology and immunohistochemistry respectively. Results ： Cytologically, 3 of the 4 cases were definitely diagnosed as lymphoid tumor and 1 suspected of small cell undifferentiated carcinoma, while histopathologically, all were diagnosed as MALT. The neoplastic cells were positive for CD20 and CD79a, but negative for CD3, CD5, CD10, CD45RO, CKpan and EMA. Conclusion： MALT is a rare pulmonary lymphoma difficult to be diagnosed. The definite diagnosis of pulmonary MALT depends on the cytology of FNA and bronchi smears, histopathology, and immunohistochemistry.