原发胸腺黏膜相关淋巴组织淋巴瘤七例报告并文献复习

目的分析原发胸腺黏膜相关淋巴组织(MALT)淋巴瘤的临床特征、病理诊断、治疗及预后,并进行相关文献复习。方法收集并分析2017年11月至2019年1月于南京医科大学第一附属医院诊疗的7例原发胸腺MALT淋巴瘤患者的临床表现、病理诊断、实验室检查、治疗及预后。结果7例患者中6例为女性,患者常无明显不适,因体检发现前纵隔肿物就诊。行前纵隔肿物切除,术后病理提示为原发胸腺MALT淋巴瘤。实验室检查显示全部患者抗核抗体、抗Ro52抗体、抗干燥综合征A抗体阳性,红细胞沉降率均升高。其中4例有干燥综合征病史。术后对所有患者进行PET-CT检查并密切随访,截至2019年7月患者生存良好,未见复发。结论原发胸腺MALT淋巴瘤临床罕见,多与自身免疫性疾病(如干燥综合征)相关,此类患者预后好,若无治疗指征,可密切随访,避免过度治疗。

Primary thymic mucosa-associated lymphoid tissue lymphoma:7 clinical cases report and a review of the literature

Objective To reveal clinical features,pathological diagnosis,treatment and prognosis of primary thymic mucosa-associated lymphoid tissue(MALT)lymphoma and review literatures.Methods The clinical characteristics,pathological diagnosis,laboratory texts,treatment and prognosis of 7 cases of primary thymic MALT lymphoma identified at the First Affiliated Hospital of Nanjing Medical University from November 2017 to January 2019 were collected and analyzed.Results Of 7 primary thymic MALT lymphoma cases,six were female.Patients were often asymptomatic and were found mediastinal mass by chest CT.After mediastinal mass resection,pathologist reported a primary thymic MALT lymphoma.Laboratory tests showed all patients were positive for anti-nuclear antibody,anti-Ro52 antibodies and anti-Sjogren’s syndrome A antibodies,and increased erythrocyte sedimentation rate(ESR).Four were diagnosed with Sjogren’s syndrome(SS).After surgery,the patients were given the positron emission tomography computed tomography(PET-CT)scans.All cases received“watch and wait”approach.Up to now,all cases showed good prognoses and none of them relapsed.Conclusion Primary thymic MALT lymphoma was rare,and it was often associated with autoimmune diseases.Such patients who usually had good prognoses should be followed up closely and avoided excessive treatments if there were no indications of intervention.