Marginal zone B-cell non-Hodgkin's lymphoma of mucosa-associated lymphoid tissue type: imaging findings

OBJECTIVE: The aim of this essay is to describe the imaging features of marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) type throughout various organs. CONCLUSION: Awareness of the expected locations of MALT lymphoma combined with knowledge of the incidence and imaging findings leads to accurate diagnosis of lesions suspicious for this disorder and helps to differentiate this disease from other abnormalities.     

肺黏膜相关淋巴组织淋巴瘤的CT诊断

目的 研究肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现,提高对该病的认识及鉴别诊断能力.方法 回顾性分析经病理证实的12例MALT淋巴瘤的CT表现,影像观察指标为病灶的数量、分布、形态、密度及伴随征象.结果 12例MALT淋巴瘤中共检出肺实变、肺肿块、肺结节、磨玻璃样病灶32个,病灶单发2例,多发10例;多发病例中单肺多发2例,双肺多发8例.肺实变10例共21个病灶,其内均可见支气管充气征,1例2个病灶内见支气管扩张;肺肿块或结节影3例共5个病灶,3个病灶内可见支气管充气征;磨玻璃样改变2例共6个病灶;1例伴纵隔及肺门淋巴结肿大.结论 MALT淋巴瘤CT上常表现为双肺多发、含有支气管充气征的肺实变、肿块、结节样或磨玻璃样改变;上述影像表现及相对缓慢的病变过程提示MALT淋巴瘤的诊断.     

肺黏膜相关淋巴组织淋巴瘤的CT表现

目的探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现,以提高对本病的认识。方法回顾性分析21例经手术、穿刺活检病理证实的肺黏膜相关淋巴组织淋巴瘤的CT影像表现。结果 21例MALT中,双侧肺分布14例(66.7%),单侧肺病灶7例(33.3%)。病灶形态呈斑片及实变影16例(76.2%),结节形或肿块样4例(19%),弥漫性间质性改变1例(4.8%)。结节状病灶、实变病灶及斑片状病灶内有较粗大的支气管充气征12例,粗大蜂窝状改变2例,MALT病灶边缘较清晰,不规则15例,伴毛刺样改变的5例,胸膜凹陷的3例,伴胸腔积液的4例。结论肺MALT淋巴瘤CT表现多样,可为单发结节影、斑片状影及实变影,亦可弥漫性间质性改变,病灶内常伴有粗大的支气管充气征,病灶周边不规则,伴毛刺及胸膜凹陷改变,上述影像表现要考虑MALT的诊断。     

Pulmonary mucosa-associated lymphoid tissue lymphoma: CT and pathologic findings

OBJECTIVE: The objective of this study was to determine the CT findings in pulmonary mucosa-associated lymphoid tissue lymphoma and to correlate these CT findings with histologic specimens. CONCLUSION: In the 11 patients reviewed, the most common CT appearance of pulmonary mucosa-associated lymphoid tissue lymphoma was consolidation with air bronchograms, correlating histologically with a cellular lymphocytic infiltrate expanding the interstitium and compressing adjacent alveoli, producing air bronchograms.     

Gastric mucosa-associated lymphoid tissue lymphoma: helical CT findings and pathologic correlation

OBJECTIVE: The purpose of this study was to describe helical CT findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to correlate them with pathologic findings. MATERIALS AND METHODS: We retrospectively reviewed CT examinations of 58 patients with confirmed gastric MALT lymphomas. Using the histopathologic grade of the MALT lymphomas, we divided the patients into two groups: those with high-grade lymphoma (n = 21) and those with low-grade lymphoma (n = 37). Common CT findings for the two groups were reviewed and compared. RESULTS: Forty (69%) of the 58 patients showed at least one abnormality of the stomach on CT. Abnormalities included diffuse or segmental gastric wall thickening (66%, 38/58), lymphadenopathy (40%, 23/58), ulcer (22%, 13/58), and gastric mass (3%, 2/58). Eighteen (31%) of 58 patients were found to have no abnormality. The high-grade group had a higher incidence of abnormalities seen on CT than the low-grade group (100% vs 51%, respectively). Gastric wall thickening in the high-grade group was more diffuse (48% vs 8%) and severe (71% vs 14%; severe or moderate) than that seen in the low-grade group. Lymphadenopathy was visualized in 67% of the high-grade group and in 24% of the low-grade group. Gastric ulcer was found in 57% of the high-grade group and in only 5% of the low-grade group. The gastric mass formation was seen in only two patients in the high-grade group. CONCLUSION: The CT findings of gastric MALT lymphoma that the two groups had in common were gastric wall thickening and lymphadenopathy. Although our results pointed to no specific CT finding for differentiating high-grade from low-grade gastric MALT lymphomas, we found that the absence of abnormality on CT is highly predictive of low-grade MALT lymphoma.     

胸腺原发黏膜相关淋巴组织淋巴瘤的CT诊断

目的探讨胸腺原发性黏膜相关淋巴组织淋巴瘤(MALToma)的CT表现和诊断价值。方法搜集本院经病理证实的胸腺原发MALToma 7例。观察胸腺MALToma的CT特征,并与6例胸腺癌及6例胸腺弥漫大B细胞淋巴瘤的CT表现进行对照。结果7例MALToma患者中男性2例,女性5例,年龄<40岁者5例(5/7),与胸腺癌(0/6)相比P<0.05),而与弥漫大B细胞淋巴瘤(6/6)比较无统计学差异;胸腺MALToma所有病灶均呈单侧生长(7/7),与弥漫大B细胞淋巴瘤(1/6)比较P<0.05,而与胸腺癌(5/6)比较无统计学意义;所有MALToma病灶均呈囊实性肿块(7/7),囊变区呈小而多发,囊与囊之间分界清楚,囊壁光滑,胸腺癌囊变多呈单个大片坏死(4/6),边缘欠清,弥漫大B细胞淋巴瘤囊变较少见(2/6,P<0.05);所有MALToma病灶均无纵隔淋巴结肿大(0/7),胸腺癌中2例出现淋巴结肿大(2/6),两者比较无统计学差异,而弥漫大B细胞淋巴瘤均有纵隔淋巴结肿大(6/6,P<0.05);所有MALToma病灶均未出现周围大血管侵犯(0/7),与弥漫大B细胞淋巴瘤(5/6)比较P<0.05,而与胸腺癌(2/6)比较无统计学差异。结论CT表现在胸腺原发性MALToma的诊断中具有一定价值。     

肺黏膜相关淋巴组织淋巴瘤的CT和临床表现及其病理学基础

目的:探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的CT表现特征及与其临床、病理表现的关系.方法:回顾性分析22例经病理确诊的肺MALT淋巴瘤患者的影像学和临床资料.22例中2例合并肺癌,5例同时有肺外累及.结果:本组患者的主要临床症状包括咳嗽咳痰12例、喘憋7例、发热4例、胸痛2例、咯血2例、盗汗2例,有2例患者无明显症状.22例的主要表现可分为2型,实变型16例(16/22,73％),肿块/结节型7例(7/22,32％).病灶密度均匀15例(15/22,68％),增强扫描均明显强化,可见血管造影征;病灶边缘均可见晕征,空气支气管征19例(19/22,86％),伴支气管扩张15例(15/22,68％).其它表现包括肺内多发小结节14例(64％),磨玻璃影11例(50％),树芽征4例(18％),胸腔积液9例(41％),肺门及纵隔淋巴结增大6例(27％).合并肺癌者CT表现为肺内单发肿块伴周围明显间质性浸润.结论:肺MALT淋巴瘤的临床表现无特异性,但其CT表现有一定特征性,对本病的诊断及鉴别诊断有重要的提示作用,确诊需依靠病理活检.     

原发性颅内外侵犯的黏膜相关性淋巴组织淋巴瘤一例

患者女,51岁.2006年6月无意中发现左侧头部隆起包块,无明显异常感觉,无红肿热痛,包块缓慢略增大,于2007年3月来我院就诊.体检发现左额、顶、颞部多发隆起包块,无明显压痛,质中等,无波动感,表面未见血管异常改变,皮肤温度正常,无抽搐,无恶心呕吐,无手足麻木及四肢障碍.脑脊液检查正常,脑脊液培养+药敏实验阴性.     

Low-grade gastric mucosa-associated lymphoid tissue lymphoma: correlation of radiographic and pathologic findings.

PURPOSE: To describe upper gastrointestinal (Gl) examination findings of low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma and to correlate them with pathologic examination findings. MATERIALS AND METHODS: A retrospective review of upper Gl examinations was performed in 25 patients with proved low-grade gastric MALT lymphomas. Upper Gl examinations were reviewed for common findings and most probable diagnosis, and these findings were correlated with pathologic findings in resected specimens in 15 patients. RESULTS: The common findings at upper Gl examination included mucosal nodularity (n = 13), ulcer (n = 12), rugal thickening (n = 6), mass (n = 4), and enlarged areae gastricae (n = 2). The most probable diagnoses were early gastric carcinoma (n = 7), advanced gastric carcinoma (n = 6), gastritis (n = 9), and lymphoma (n = 3). Of 17 lesions found on resected specimens, six ulcers and two masses were not depicted at barium study. Disorganized convergent rugae projecting to multiple points and vague ulcer margins were present in four and seven lesions, respectively. Multiple ulcers were seen in two patients. CONCLUSION: Although the common radiographic and pathologic findings observed in low-grade gastric MALT lymphomas were similar to those of gastric carcinomas or gastritis, disorganized convergent rugae, vague ulcer margins, and multiplicity of lesions may be helpful in differentiating them from gastric carcinomas or gastritis.     

胸腺原发性黏膜相关淋巴组织淋巴瘤2例

例1女,41岁.体检发现纵隔肿物入院,主诉口干、眼干等症状,入院诊断为干燥综合征.行胸部CT平扫和增强(图1A～C),显示前上纵隔可见密度不均的结节影,大小为2.0 cm×1.5 cm,边缘光整、锐利,平扫CT值约为21 HU,增强两期CT值分别为62 HU、67 HU,呈环形不均匀强化.影像诊断:胸腺瘤.全麻下行胸腔镜经右纵隔肿物及全胸腺切除术,术中见不规则的灰白肿物,一侧有包膜.切面灰白,略显黏液样外观,分叶状,质脆,未累及胸膜被膜.免疫组化结果显示(图1D):CD20(+),CD21 FDC(网+),CD3(-),CD34血管(+),CD79α(+),CK上皮(+),Ki-67(+10％),Kappa少量(+),Lambda多量(+).光镜下所见(图1E):淋巴组织增生,见大量大小较一致的异型细胞,异型细胞排列密集,胞质较少,局部可见淋巴上皮病变.病理诊断:胸腺黏膜相关淋巴组织淋巴瘤.术后6个月随访,未见复发和转移.     

原发性肝脏黏膜相关边缘区B细胞淋巴瘤的诊断(附1例报告并文献复习)

目的提高对原发性肝脏黏膜相关边缘区B细胞淋巴瘤(MALT)的认识,探讨诊治方法。方法回顾性分析1例以午后间歇性低热、盗汗为首发表现的原发性肝脏MALT患者的临床资料,并通过复习相关文献,总结诊治经验。结果原发性肝脏MALT患者的临床表现无特异性,影像学检查易误诊为原发性肝癌。本例患者在排除肝内结核和原发性肝癌的基础上,行经皮CT引导下穿刺活检。标本的免疫组化检查示:Ki-67增殖活性15%～20%,CD20、CD79a、Bcl-2和PaX-5阳性,CD5、CD10、CD3、CD7、CD23、CD43、MUM1及cyclinD1阴性。根据病理学检查结果 (典型的淋巴上皮病变)可确诊原发性肝脏MALT。给予利妥昔单抗联合氟达拉滨方案化疗6个疗程,患者获得完全缓解,随访至2010-04-21已存活12个月。回顾性分析文献中49例原发性肝脏MALT,患者中位发病年龄62(36～85)岁,男∶女为0.91∶1。影像学检查以孤立性病变较多见,氟-18标记的氟代脱氧葡萄糖正电子断层显像-CT(18F-FDGPET-CT)扫描有助于对肝脏MALT淋巴瘤进行分期。手术治疗是最常用的治疗方法 ,推荐在行手术治疗后联合化疗或免疫治疗。结论原发性肝脏MALT罕见,起病隐匿,临床表现不典型,确诊主要依靠组织病理学结果和免疫表型特征,淋巴细胞IgH基因重排和染色体易位检测等遗传学和分子生物学检查是重要的辅助检查手段。     

胃黏膜相关淋巴组织淋巴瘤临床病理学观察

目的 :研究胃黏膜相关淋巴组织 (MALT)淋巴瘤的临床病理学特点。方法 :收集 2 4例原发于胃的MALT淋巴瘤 ,石蜡切片 ,HE染色 ,组织病理学观察 ,免疫组化S -P法检测。结果 :本组发病男女比为 2∶1,年龄 19～ 82岁 ,平均 5 1.5 6岁。术前均作胃镜活检。形态学表现高恶性 3例 ,低恶性 2 1例中 2例临床为高恶性。结论 :胃MALT型淋巴瘤临床表现、胃镜与影像学检查不能与胃癌鉴别 ,正确诊断依赖病理活检。早诊断早治疗 ,包括外科治疗、放疗、化疗 ,同时辅以抗幽门螺杆菌 (Helicobacterpylon ,HP)治疗 ,以提高患者生存期和治愈率     

Gastric mucosa-associated lymphoid tissue lymphoma: spectrum of findings at double-contrast gastrointestinal examination with pathologic correlation.

Mucosa-associated lymphoid tissue (MALT) is found in the surface epithelium of the stomach. MALT lymphoma is extranodal lymphoma originating from MALT. In the stomach, a strong association with Helicobacter pylori infection has been demonstrated. Low-grade gastric MALT lymphoma has been reported to have variable features at upper gastrointestinal (UGI) examination. Twenty-two patients with low-grade MALT lymphoma had ulcers (n = 11), fold thickening (n = 7), mucosal nodularity (n = 7), masses (n = 6), or prominent areae gastricae (n = 4) at UGI examination. Six patients with high-grade MALT lymphoma had masses (n = 4), fold thickening (n = 3), ulcers (n = 1), or mucosal nodularity (n = 1) at UGI examination. These findings were similar to those in gastric carcinoma or gastritis. Differentiation of low-grade MALT lymphoma from gastritis or gastric carcinoma was more difficult than differentiation of high-grade MALT lymphoma. Lesions of MALT lymphoma associated with H pylori gastritis were diffuse or multiple in 65% of cases; however, lesions of MALT lymphoma without proved H pylori gastritis were focal or solitary in 80% of cases. Therefore, multiplicity of lesions in MALT lymphoma was closely associated with H pylori infection.     

眼眶原发性黏膜相关淋巴组织淋巴瘤的CT、MRI诊断

目的 探讨CT、MRI对眼眶原发性黏膜相关淋巴组织淋巴瘤( mucosa-associated lymphoid tissue lymphoma,MALToma )的综合诊断价值.方法 收集经手术病理证实的眼眶原发性MALToma 12例,其中11例行眼眶MR扫描,6例行眼眶CT扫描.重点观察眼眶原发性MALToma病灶的数目、位置、形态、对眶周结构的侵犯及影像学特征.结果 12例中,单侧发病10例,双侧发病1例,另1例首先左眼发病,手术切除病灶2年后右眼再发.CT、MRI能准确地反映病灶的眶内位置、形态及邻近结构的累及情况.6例眼眶MALToma病例CT上均表现为等-稍高密度软组织肿块,CT值介于46~66 HU.其中1例行增强扫描,其病灶平扫CT值66 HU,增强后CT值约94 HU,强化均匀.所有病灶均未伴发肿瘤灶内钙化及周边骨质侵犯.11例眼眶MALToma病例行MRI检查,T1加权呈等-稍高信号,T2加权呈等-稍高信号,信号均匀.其中7例行增强扫描,病灶呈中度至明显均匀强化.结论 常规CT及MRI扫描均有利于眼眶原发性MALToma的定位诊断,其特征性的影像学表现可提高术前定性诊断率.     

原发性肺黏膜相关淋巴组织淋巴瘤的18F-FDG PET/CT影像学表现

目的 分析原发性肺黏膜相关淋巴组织（MALT）淋巴瘤的18F-FDG PET/CT影像学表现,提高对原发性肺MALT淋巴瘤的认识及诊断能力。 方法 回顾性分析2006年11月至2017年4月经病理确诊的9例原发性肺MALT淋巴瘤患者（男性6例、女性3例,中位年龄59岁）的临床资料及18F-FDG PET/CT显像资料,记录病灶的部位、数量、密度、大小、形态及最大标准化摄取值（SUV_max）,以及纵隔及肺门淋巴结等情况;分析影像信息并同时进行相关文献复习。 结果 9例原发性肺MALT淋巴瘤患者18F-FDG PET/CT表现分为3型:实变型4例、肿块型3例、弥漫肺炎型2例。实变型表现为大小、受累范围不等的实变影;肿块型表现为单发或多发、边缘毛糙的实性肿块影;弥漫肺炎型表现为肺叶内或双肺弥漫的斑片、团块样软组织密度影。在9例患者中可见支气管充气征8例（部分伴有支气管扩张）、三角型灌注征3例、病灶向中心聚拢4例、钙化2例、胸腔积液2例、肺门及纵隔淋巴结肿大2例。所有病灶18F-FDG 代谢不均匀增高,中位SUV_max为6.0（2.6~8.3）;2例弥漫肺炎型纵隔及肺门淋巴结18F-FDG摄取异常增高,SUV_max分别为13.0、4.7。 结论 原发性肺MALT淋巴瘤的18F-FDG PET/CT表现常为斑片状致密影,多见实变影,内部常见支气管充气征,18F-FDG轻度摄取,结合相对缓慢的病程,可考虑为原发性肺MALT淋巴瘤。