肺黏膜相关淋巴组织样淋巴瘤7例并临床诊断与分析

Clinical diagnosis and analysis of primary pulmonary mucosa-associated lymphoid tissue lymphoma:A report of seven cases

目的:探讨肺黏膜相关淋巴组织样淋巴瘤(mucosa associated lymphoid tissue,MALT)临床、病理特点,诊断及治疗。方法:回顾7例肺MALT患者临床资料,结合文献对其临床及病理特点、免疫组织化学(CD20,CD79a,CD5,CD10,CD23,CyclinD1,Ki-67等)、诊断等进行总结分析。结果:7例患者男3例、女4例,男女比例:1:1.3。平均年龄58岁。4例患者存在吸烟、肺部反复感染等慢性免疫系统刺激因素。无症状体检发现者2例,余患者主要表现为:咳嗽、气促及不规则发热。胸部影像学表现为多发性浸润病变,双肺多发者4例,右肺者3例,胸腔积液5例。所有患者均呈CD19(+),CD20(+)。Ki-67阳性率较低。CD5、CD10、CyclinD1阴性。结论:肺MALT大多数临床及影像学表现缺乏特异性,误诊率高,确诊依赖于组织病理学检查。

Objective：This study aims to examine the clinicopathological features, diagnosis, and treatment of pulmonary margin-al zone B-cell lymphoma of mucosa-associated lymphoid tissue （PMZL-MALT）. Methods：The clinicopathological features and immu-nohistochemical staining of CD20, CD79a, CD5, CD10, CD23, CyclinD1, and Ki-67 in seven patients with PMZL-MALT were ana-lyzed. Results：These patients, with a median age of 58 years, included three males and four females. Most of the patients suffered from cough, anhelation, and irregular fever. No specific imaging manifestation was observed. Tumor cells were positive for CD19 and CD20 but negative for CD5, CD10, and CyclinD1. The positive rate of Ki-67 was low. Conclusion：PMZL-MALT cases are easily misdiag-nosed because of the absence of specific clinical characteristics and X-ray features. Final diagnosis depends on pathological examina-tions.