胃肠道黏膜相关淋巴瘤27例临床病理分析

Clinical analysis of 27 cases of mucosa-associated lymphoid tissue lymphoma in gastrointestinal tract

目的探讨胃肠道黏膜相关淋巴瘤临床病理特点,为其诊断及治疗提供依据。方法分析27例淋巴瘤患者肿瘤组织标本的形态学特点,采用免疫组织化学SP法标记白细胞共同抗原(LCA)、CD20、CD79α、CD45RO、CD3、CD23、CD43、CK以及Ki-67。结果 27例淋巴瘤中胃17例(62.96%),回盲部5例(18.52%),乙状结肠3例(11.11%),空肠2例(7.40%)。组织学特点:瘤细胞为边缘区B细胞、单核样B细胞、多少不等的小淋巴细胞、浆细胞及转化的大细胞。淋巴上皮病变18例(66.67%),滤泡克隆化9例(33.33%)。LCA(+)、CD20(+)、CD79α(+)27例,Ki-67(+)25例,CD43(+)9例,CK腺上皮(+)27例,CD45RO(-)、CD3(-)、CD23(-)27例。结论胃肠道黏膜相关淋巴瘤为低度恶性淋巴瘤,病理诊断主要基于形态学,结合免疫组织化学有助于正确诊断和鉴别诊断。

Objective To explore clinical characteristics of mucosa-associated lymphoid tissue（ MALT） lymphoma,amd provide guide to diagnosis and treatment. Methods Morphological characteristcs of 27 cases of lymphoma were analyzed. Immunohistochemical staining were performed with LCA,CD20,CD79？？CD45RO,CD3,CD23,CD43,CK and Ki-67 in 27 cases of MALT lymphoma. Results Among 27 cases of MALT lymphoma,17 cases were in stomach（ 62. 96% ） ,5 cases in ileocecal junction（ 18. 52% ） ,3 cases in sigmoid colon （ 11. 11% ） ,2 cases in jejunum （ 7. 40% ）. Histological features：The tumor cells are marginal zone B cell,monocytoid B cell,more or less small lymphocyte,plasma cell transformed cell. There were 18 cases of lymphoepithelial lesions（ 66. 67% ） ,9 cases of follicular colonization（ 33. 33% ） ,LCA,CD20 and CD79？？was positive in 27 cases,Ki-67 was positive in 25 cases,CD43 was positive in 9 cases,CK glandular epithelium were positive in 27 cases,CD45RO,CD3,and CD23 was negative in 27 cases. Conclusion MALT lymphoma is a kind of low grade malignant lymphoma; pathologic diagnosis mainly bases on hematoxylin-eosin staining morphology; combination with immunochemistry is helpful to the diagnosis and differential diagnosis.