胃黏膜相关淋巴组织淋巴瘤72例临床病理分析

The clinicopathological diagnosis in 72 cases of gastric mucosa-associated lymphoid tissue lymphoma

目的探讨胃黏膜相关淋巴组织淋巴瘤(mucosa-associated lymphoid tissue,MALT)的内镜和病理特征,以减少误诊、漏诊,提高诊断正确率。方法对1994年1月到2007年6月在本院经病理证实的72例胃MALT的临床、内镜和病理资料进行回顾性分析。结果72例患者平均59岁,临床症状无特殊性。肿瘤同时累及胃体、胃角、胃底、胃窦部中的2个或多个部位占68.06%,病理形态学改变表现:肿瘤组织为反应性淋巴滤泡。该组病例内镜活检确诊率为25%,术后病理确诊率达100%,免疫组织化学证实为B细胞淋巴瘤。结论内镜下多块取检、深取检,结合以上病理特点和免疫组织化学,有助于诊断胃MALT。

objective To study the clinical and pathological features of gastric mucosa associated lymphoid tissue （MALT） lymphoma to improve the rate of accurate diagnosis.Methods The clinical,endoscopic and pathological data of 72 patients with gastric MALT lymphoma diagnosed pathologically were analyzed retrospectively.Results The patients with gastric MALT lymphoma had a median age of 59 years,their symptoms were nonspecific.Endoscopy showed the lesion frequently（in 49/72 or 68.06%） involved two or more portions of the stomach,while solitary tumors in the other 23 cases were located at the gastric fundus,antrum or angulus.Histopathololgy showed the tumor consisted of reactive lymph follicles.The rate of correct diagnostic was 25% by endoscopy but was up to 100% by postoperative pathologiy.Immunohistochemistry analysis showed the tumor belonged to B-cell lymphoma.Conclusions Multiple deep biopsy,special pathological changes and mmunohistochemistry will help to reach the correct diagnosis of gastric MALT lymphoma.