肺粘膜相关型淋巴瘤与肺炎性假瘤临床病理及免疫组化研究

A clinicopathological and immunohistochemical study between pulmonary MALT type lymphoma and inflammatory pseudotumor

目的 :探讨肺粘膜相关型淋巴瘤和肺炎性假瘤的病理特征及相互关系。方法 :对 9例肺粘膜相关型淋巴瘤和 6例肺炎性假瘤进行临床病理及免疫组化研究。结果 :男性多见 ,平均年龄 5 8岁 ,干咳、胸闷、胸痛为主要症状。病理形态 :肺粘膜相关型淋巴瘤 9例 ,细胞类型 ,CCL细胞性 6例、小淋巴细胞性 2例 ,淋巴浆细胞性 1例。肺炎性假瘤 6例。免疫组化证实 ,肺粘膜相关型淋巴瘤 9例LCA+ 、L2 6 + 、IgM、κ或λ呈单克隆性 ,6例炎性假瘤显示多克隆性。 结论 :两者临床鉴别困难 ,病理诊断须依靠免疫组化才能鉴别 ,两者均应以手术治疗为主。

Purpose To study the pathological characteristic and the relationship between pulmonary MALT type lymphoma and inflammatory pseudotumor. Methods Nine cases of pulmonary MALT type lymphoma and six cases pulmonary inflammatory pseudotumor were studied by clinicopathology and immunohistochemistry. Results Male patients were more common than female ones. The average age was 58 years old. Dry cough, chest distress and pectoralgia were the main symptoms. Histopathologically, there were six cases of CCL type, two small lymphocytic type and one lymphoplasmacytic type in the nine cases of the pulmonary MALT type lymphomas. The other six cases were inflammatory pseudotumors. Immunohistochemically, all the lymphomas showed LCA(+), L26(+), IgM(+), kappa or lambda positive. While the inflammatory pseudotumors were both kappa and lambda positive. Conclusion It is very difficult for the clinicians to make a differential diagnosis between the two lesions. Both histopathology and immunohistochemistry are important for the diagnosis. Surgical operation is suggested to be the main treatment for them.