原发性肺黏膜相关淋巴组织B细胞淋巴瘤临床病理分析

Clinical Analysis of Primary Pulmonary Mucin-associated Lymphoid Tissue Lymphoma

目的探讨肺原发性黏膜相关淋巴组织B细胞淋巴瘤(MALToma)的临床诊断及治疗,提高对肺MALToma的认识,为该类肿瘤的诊疗提供参考。方法回顾性分析7例肺原发性MALToma患者的临床特点、影像学表现、组织病理学特征,并复习相关文献。结果多数患者以反复咳嗽、咳痰为主要临床表现;胸部影像学检查多显示病变侧肺叶内大片状软组织高密度影,内可见空气支气管征;组织病理学及免疫组织化学检查结果显示为肿瘤细胞弥漫表达B细胞标记(CD20、CD79α),不表达T细胞标记(CD43、CD3)及神经内分泌标记(Syn、CgA、CD56)。结论肺原发性MALToma属于低度恶性B细胞淋巴瘤,综合分析患者临床特点、影像学、组织病理学及免疫表型可以明确诊断。

Objective To investigate the clinical diagnosis and treatment of primary pulmonary mucin-associated lymphoid tissue lymphoma（MALToma） and to improve the knowledge of MALToma and to provide reference for treatment.Methods Seven cases of primary pulmonary MALToma were analyzed by clinical feature,radiographic and pathological characters,and meanwhile the related literatures were reviewed.Results The most common manifestations were recurrent cough and sputum.Chest computed tomography（CT） demonstrated high density shade of large soft tissues in pulmonary lesions with air bronchogram.Histopathology and immunohistochemical findings revealed that most of the tumor cells were widely positively stained for CD20 and CD79α,but negative for CD43,CD3,Syn,CgA and CD56.Conclusion Primary pulmonary MALToma is very rare with low grade B-cell types.It can be diagnosed with combination of the clinical characters,radiographic features,histopathology and immunophenotypic findings.