32例胃黏膜相关淋巴组织淋巴瘤内窥镜活检病例的临床病理及免疫表型分析

Primary gastric mucosa-associated lymphoid tissue lymphoma in endoscopic biopsied specimens: a pathological analysis of 32 cases

目的:探讨胃黏膜相关淋巴组织(mucosa-associated lymphoid tissue,MALT)淋巴瘤的黏膜活检病例临床病理诊断特点。方法:用常规石蜡包埋切片、染色和免疫组化染色后光镜下观察,个别病例行IgH/L基因重排检查。结果:活检组织中均见不同程度的异型淋巴细胞弥漫浸润,腺体数量减少或完全消失。32例中有19例出现淋巴上皮病变或可疑淋巴上皮病变;15例出现炎症渗出坏死和组织挤压损伤等伴发病变。结论:异型淋巴细胞弥漫浸润是活检诊断的主要特征,活检组织中可能不出现淋巴上皮病变,常伴有其他组织学改变;内窥镜下多块、深部取检,结合该病的临床病理学特点及免疫组化染色和分子生物学技术可以提高胃MALT淋巴瘤诊断的准确率。

Objective： To investigate the pathological characteristics of gastric mucosa associated lymphoid tissue（MALT） lymphoma in endoscopic biopsied specimens.Methods： All the tissue samples were 10% formalin-fixed,paraffin-embedded and stained with hematoxylin-eosin and SP immunohistochemistry.Results： There were variable atypia,diffuse lymphoid cell infiltration with decrease or disappearance of the gland in the biopsied sample.The lymphoepithelial lesions were seen in 12 cases and suspected lymphoepithelial lesions in 7 cases.There were inflammatory necrosis and pressing tissues injury in 15 cases.Conclusion： The main diagnostic characteristics of gastric lymphoma were variable atypia,diffuse lymphoid cell infiltration in the biopsied tissues.Lymphoepithelial lesions were not always observed,but other changes were often seen in the biopsied samples.Multiple deep biopsy,special pathological changes,immunohistochemistry and molecularbiology techniques will help to reach the correct diagnosis of gastric MALT lymphoma.