胃黏膜相關淋巴組織淋巴瘤8例臨床病理分析

Clinicopathologic study of 8 case of mucosa-associated lymphoid tissue lymphoma of stomach

目的研究胃黏膜相關淋巴組織(MALT)淋巴瘤的臨床病理特征。方法回顧性分析鏡湖醫院2010年~2015年胃MALT淋巴瘤病例8例,採用常規HE染色、免疫組織化學染色,GIEMSA染色,分析其臨床病史及病理學特點。結果胃MALT淋巴瘤臨床胃鏡檢查均呈慢性胃炎,好發於老年人,平均年齡65歲,8例中有3例合併感染幽門螺桿菌。常規HE染色均見大量腫瘤性淋巴細胞浸潤伴淋巴上皮病變,其中4例伴不同程度漿細胞樣分化,免疫組織化學染色顯示腫瘤細胞CD20陽性、CD3陰性。有漿細胞樣分化的病例Kappa/lambda存在克隆性免疫球蛋白輕鏈限制。結論胃MALT淋巴瘤病人早期臨床症狀、胃鏡檢查及病理檢查與慢性胃炎相似,對可疑病例須行免疫組織化學檢測確定診斷。

Objective To study the clinicopathological features of mucosa-associated lymphoid tissue(MALT)lymphoma of stomach.Methods Eight cases of gastric MALT lymphoma were collected in Kiang Wu Hospital from 2010 to 2015,and the clinicopathological features were analyzed by hematoxylin and eosin staine,immunohistochemistry and Helicobacter pylori test.Results MALT lymphomas mimic gastritis at clinical and gastroscopy findings.The patients were older adults with average age of 65 years.Three out of 8 cases were associated with chronic Helicobacter infection.All 8 cases showed large amount of neoplastic lymphoid cells infiltration with lymphoepithelial lesion and plasmacytic differentiation.Immunophenotyping showed that the tumor cells were positive for B-cell markers(CD20),but negative for CD3.Kappa or Lambda immunostain showed immunoglobulin light chain restriction.Conclusion Patients with MALT lymphoma often present with a long history of nonspecific symptoms.Diagnosis of MALT lymphoma on the basis of endoscopy small biopsy specimens may be sometimes difficult.Immunohistochemical stains can improve the diagnosis in some suspicious cases.