胃粘膜相关淋巴组织型淋巴瘤形态学研究

Gastric mucosaassociated lymphoid tissue type lymphoma

目的：研究胃粘膜相关淋巴组织（ＭＡＬＴ）型淋巴瘤及其与胃粘膜套细胞淋巴瘤和滤泡性淋巴瘤的鉴别诊断。方法：应用ＨＥ染色和免疫组化ＡＢＣ法检测胃ＭＡＬＴ型淋巴瘤，内镜作幽门螺杆菌（ＨＰ）培养或尿素试验检测ＨＰ感染。结果：３１例胃ＭＡＬＴ型淋巴瘤中低度恶性２７例，高度恶性４例。细胞类型以ＣＣＬ型最常见。免疫表型以ＩｇＭ为主，缺乏ＩｇＤ。３１例中２８例有ＨＰ感染（占９０．５２％）。结论：①低恶ＭＡＬＴ型淋巴瘤常见到淋巴上皮病变，滤泡性克隆化和反应性滤泡，具有诊断和鉴别诊断价值。②高恶ＭＡＬＴ型淋巴瘤伴有低恶成分。

Purpose To study gastric mucosaassociated lymphoid tissue (MALT) type lymphoma, and the differential diagnosis between mantle zone lymphoma, follicle lymphoma, and follicle reactive hyperplasia. Methods Using HE staining and immunohistochemistry (ABC method) for the histopathology of gastric MALT lymphoma, endoscopy biopsy for the tissue culture of Helicobacter Pylori (HP) urea test for the detection of HP. Results Thirtyone cases of gastric MALT lymphoma were described. Among them 19 were male and 12 female. The average age was 51 years. Of which 27 were low malignant and 4 high malignant. Cytologically, centrocytelike cell type was the most common one. The main immunephenotype was IgM, Lacking IgD. 28 among the 31 cases (9052%) had HP infection. Conclusions (1) Lymphoepithelial lesion, follicular colonization and reactive hyperplasia are often observed in low grade MALT lymphoma, which has diagnostic and differential diagnostic value. (2) High malignant lymphomas are accompanied with low grade component. (3) HP infection might be the cause of the formation of MALT and might resulted in MALT lymphoma.