肺黏膜相关淋巴组织淋巴瘤的临床与影像表现

Clinical and Imaging Manifestations of Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma

目的研究肺黏膜相关淋巴组织(MALT)淋巴瘤的临床及影像表现。方法对13例经病理证实的肺MALT淋巴瘤的临床及CT影像表现进行回顾性分析。结果 13例患者中,7例无明显症状,6例表现为呼吸道症状,包括咳嗽、咳痰及喘憋等,1例伴有发热。CT表现为单发结节2例,多发结节3例;单发实变3例,多发实变5例。所有患者的CT影像均可见支气管充气征,伴发支气管扩张4例;伴发磨玻璃影5例;伴发肺间质病变5例。伴发淋巴结肿大1例,胸腔积液2例。病理均提示大量淋巴细胞浸润,并可见核异型细胞,为B细胞来源。结论肺MALT淋巴瘤主要表现为肺部实变、结节或肿块影伴支气管充气征,淋巴结肿大少见,惰性临床病程,可伴有自身免疫性疾病,如有上述表现应考虑肺MALT淋巴瘤的可能,其诊断依赖病理并结合免疫组织化学检查。

To investigate the clinical and computed tomography （CT） appearances of pulmonary mucosaassociated lymphoid tissue （MALT） lymphoma. Methods The CT findings and clinical data of 13 patients with pathologically proven pulmonary MALT lymphoma were retrospectively reviewed. Resuits Among these 13 patients, seven presented no notable abnormalities, six manifested respiratory symptoms including cough, expectoration, and dyspnea; one of these six patients experienced fever. Chest CT showed solitary nodule in 2 patients and multiple nodules in 3 patients; meanwhile, it showed solitary consolidation in 3 patients and multiple consolidations in 5 patients. Other CT findings included air bronchogram （ n = 13 ） , airway dilatation （ n = 4 ）, ground glass opacities （ n = 5 ）, and interstitial changes （ n = 5 ）. One patient had mediastinal lymphoadenopathy and 2 had pleural effusion. Pathology showed massive lymphocyte infiltration; cells with notable nuclear atypia were also seen, which were generated from B cells. Conclusions The main CT findings of pulmonary MALT lymphoma include nodules, mass or patchy consolidations with air brochogram ; hilar and mediastinal lymphadenopathies are rare. Clinical diagnosis should also be based on pathological findingsand immunohistochemical results.