肺原发性支气管相关淋巴组织淋巴瘤临床分析

Clinical analysis of primary pulmonary bronchus-associated lymphoid tissue lymphoma

目的 探讨肺原发性支气管相关淋巴组织（BALT）淋巴瘤的临床诊断及治疗,提高对BALT淋巴瘤的认识.方法 分析肺原发性BALT淋巴瘤的临床特点、影像学表现、病理特征、临床诊断,并复习文献.结果 患者以反复咳嗽、咳痰伴胸闷、气促为其特点;胸部CT检查显示：双肺多发大片实变影,右侧胸腔积液;CT引导下经皮肺穿刺活检病理检查结果：黏膜相关淋巴组织结外边缘带小B淋巴细胞淋巴瘤,免疫表型：CD20、BCL-2、ki-67、PAX-5均阳性;CD3、CD5、CD10、CD23、CD43、cyclin-D1、MPO等表达均阴性.结论 BALT淋巴瘤临床罕见,属于低度恶性B细胞淋巴瘤,依靠组织细胞学病理、免疫表型与临床、影像学相结合可明确诊断.

Objective To investigate the clinical diagnosis and treatment of primary puhnonary bronchus-associated lymphoid tissue（BALT） lymphoma,and improve the knowledge of BALT lymphoma. Methods One case of primary pulmonary BALT ]ymphoma was investigated by clinical feature, radiographic ,pathological findings and diagnosis, meanwhile review the literatures. Results The patient characterized recurrent cough and sputum, accompanied with chest tightness and shortness of breath. Chest computed tomography（CT） demonstrated bilateral muhiple consolidation and pleural effusion in right. CT- guided transthoracic lung biopsy showed extranodal marginal zone small B lymphocytic lymphoma of BALT type. Immunophenotypic findings revealed positive staining for CD20, BCL-2, ki-67 and PAX-5, but negative for CD3 ,CD5 ,CD10, CD23, CD43, cyclin-D1, MPO. Conclusions BALT lymphoma is very rare with low- grade B-cell types. It can be diagnosed with combination of the cytologic and histologic results, Immunophenotypic findings as well as clinical and radiographic features.