腮腺黏膜相关淋巴组织淋巴瘤的临床特点分析

Analysis of the clinical features of mucosa-associated lymphoid tissue lymphoma of the parotid gland

目的:总结腮腺黏膜相关淋巴组织(MALT)淋巴瘤的临床特点,提高其临床诊断及治疗水平。方法:回顾性分析10例腮腺MALT淋巴瘤患者的临床表现、影像学特征、病理免疫组织化学检查结果、手术治疗及预后资料。结果:10例患者临床表现为耳垂下无痛性渐大肿块,其中累及腮腺浅叶8例,深叶2例。CT扫描为等、高软组织密度影,偶见钙化及坏死,增强扫描时肿块轻中度强化,周围增强或延迟增强。病理检查表现为弥漫性淋巴细胞浸润,并形成上皮-肌上皮岛样病灶,免疫组织化学证实其来源为B细胞淋巴瘤。10例患者均接受手术治疗,按肿瘤部位不同,分为腮腺浅叶切除术或腮腺全切除术。术后随访1~7年,均未见肿瘤复发。结论:腮腺MALT淋巴瘤诊断需结合临床、影像学及病理免疫组织学,治疗以手术切除为主,术后结合放化疗,预后良好,长期疗效还需进一步观察。

Objective：To investigate clinical features of mucosa-associated lymphoid tissue lymphoma（MALT）of the parotid gland.Method：Retrospective analysis was made in 10 patients who were dignosed as MALT of the parotid gland.Clinical symptoms,CT scanning and pathologic immunohistochemistry data,surgery procedure and prognosis were collected for analysis.Result：The main complain of patients was slow growing masses under the earlobes without pain.The lesion location was found at the superficial lobe of the parotid gland in 8 cases and deep lobe in 2 cases,respectively.CT scanning exhibited density isodense or hyperdense nodules,with occasional calcification and necrosis in these patients.Enhancement CT scanning exhibited lower or moderate enhancement,circumambient enhancement or delayed enhancement.Pathological examinations showed that the gland was heavily infiltrated by lymphoid cells and epimyoepithelial island were frequently observed.B-lymphocyte was found positive in these patients by histopathological examination.All patients underwent surgical treatment.According to the tumor sites,patient received the superficial parotidectomy or total parotidectomy.The postoperative follow-up period was 1 to 7 years.No tumor recurrence occurred in any patients during the follow-up time.Conclusion：The diagnosis of MALT lymphoma of the parotid gland should combined with clinical manifestation,imaging examination and pathology.symptoms,CT scanning and pathologic immunohistochemistry data.Surgery was the major treatment,combined with postoperative radiation and chemotherapy,the prognosis is good,However,long-term efficacy need further observation.