原发性肝黏膜相关淋巴组织淋巴瘤临床病理特征

目的：探讨原发性肝黏膜相关淋巴组织(MALT)淋巴瘤的临床病理特征及治疗方法。方法：对1例原发性肝MALT淋巴瘤的发病因素、临床表现、病理特征及治疗结果进行分析。结果：腹部B超检查发现肝左叶低回声区。腹部MRI检查示肝脏恶性占位性病变，行肝左叶切除术，病理检查示正常肝小叶结构破坏，被弥漫分布的肿瘤细胞替代，瘤细胞以单核样细胞为主，伴有淋巴上皮病变形成，免疫组化示，CD45、CD20、CD79a阳性，CD5、CD10、ALK、TdT阴性，HCV、HBV和EBV阴性。结论：原发性肝MALT淋巴瘤属低度恶性B细胞淋巴瘤，有独特的临床、组织病理学和免疫表型特点。治疗上多采取手术局部切除治疗，部分需加用联合化疗。     

15例黏膜相关淋巴组织淋巴瘤临床分析

目的:探讨黏膜相关淋巴组织淋巴瘤(MucosaAssociatedLymphoidTissueLymphoma,MALToma)的诊断、治疗及预后。方法:分析总结经病理证实的15例MALToma的临床病理资料、治疗结果和预后因素。结果:本组病例平均随访28.73±12.92月(7~50月),死亡3例,均为IVEB期。MALToma以低度恶性多见,临床表现无特异性,有特征性的病理学表现和临床生物学行为。结论:临床病理分期是决定MALToma预后的主要因素,正确诊断对估计患者预后及指导临床治疗具有重要意义。     

黏膜相关淋巴组织淋巴瘤61例临床分析

黏膜相关淋巴组织淋巴瘤 (简称ＭＡＬＴＬ)属淋巴结以外与黏膜组织相关的一种肿瘤性疾病。早期易误诊 ,其发病率有增高趋势 ,且临床缺乏特征性表现 ,与其他恶性肿瘤难以鉴别。为提高对该病的诊断和治疗的认识 ,我院自 1984年 1月至 1999年 6月期间收住的 6 1例ＭＡＬＴＬ的诊断和治疗及随访资料作回顾性分析。一、临床资料1 对象 :6 1例中男 41例 ,女 2 0例。年龄 7～ 84岁 ,中位年龄 6 1岁 ,均经病理确诊 ,其中 2 3例做了免疫组化检测。中位确诊时间 3 5个月。发病到确诊时间为 2 8ｄ至 30个月。2 肿瘤生长部位 :胃 17例 ,肠道 2 1例。鼻…     

肺黏膜相关淋巴组织淋巴瘤临床特征分析

目的：提高肺黏膜相关淋巴组织淋巴瘤诊治水平。方法回顾性分析江西省人民医院及南昌大学第二附属医院自2005年1月至2015年1月确诊的8例肺黏膜相关淋巴组织淋巴瘤的临床表现、影像学特点、诊断手段、误诊情况、治疗及预后。结果8例肺黏膜相关淋巴组织淋巴瘤中男6例,女2例,年龄38~75岁,中位年龄65岁。主要症状：咳嗽(5例)、咳痰(4例)、发热(2例)、胸闷(4例)、乏力(3例)、消瘦(3例),无症状2例。胸部 CT 表现：双肺分布5例,单肺分布3例,实变影5例,肿块及结节影4例,斑片状浸润影3例,支气管充气征5例,钙化1例,空洞2例。确诊方法：经气管镜活检1例,CT 引导下经皮肺穿刺5例,外科手术2例。误诊分析：5例误诊为细菌性肺炎,1例误诊为肺真菌病,1例误诊为肺癌,1例误诊为肺转移癌。治疗及预后：2例外科手术患者术后未行放化疗,4例转入血液内科行化疗(CHOP 方案),2例放弃治疗。8例患者随访时间2~105个月,2例死亡,6例存活。结论肺黏膜相关淋巴组织淋巴瘤临床表现不典型,容易误诊,诊断需要组织病理活检。     

原发性肺黏膜相关淋巴组织淋巴瘤4例临床病例分析

目的 总结原发性肺黏膜相关淋巴组织(MALT)淋巴瘤的临床表现、影像学特点、诊断手段、治疗方法及预后,提高临床诊治水平.方法 回顾性分析4例经病理确诊的原发性肺MALT淋巴瘤的临床资料并随诊分析预后.结果 4例原发性肺MALT淋巴瘤患者均为老年女性,为原发性肺非霍奇金淋巴瘤的最常见类型.其中3例为查体发现,1例因咳嗽、咳痰和痰中带血就诊.发病时间为7个月至5年.肺部体征无特异性.血炎症指标和肿瘤相关指标多为正常.影像学以肿块影和结节为主要表现.患者肺通气和弥散功能正常.经胸腔镜、CT引导下肺穿刺、开胸手术获取病变组织而确诊.病理表现为弥漫浸润生长的小淋巴细胞,可见淋巴上皮增生.治疗主要是化疗和手术.随访1～8.8年,1例随访4.5年时可疑复发,其余3例均病情稳定.结论 肺原发性MALT淋巴瘤为少见病,好发于老年女性,起病隐匿,临床表现不典型.诊断须靠有经验的病理专家作出.治疗尚无指南,无症状者可采取“观察等待”策略,待肿瘤进展或出现症状时,首选苯丁酸氮芥化疗,联合利妥昔单抗与否均可.预后良好,但复发率高.     

原发气管黏膜相关淋巴组织淋巴瘤1例

<正>原发气管黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)临床较为罕见,现将1例以刺激性干咳为主要症状的纤支镜组织病理学诊断为原发气管MALT淋巴瘤的病例报道如下。1病例资料男性患者,50岁。因刺激性干咳2个月于2013年5月就诊于我院呼吸内科。患者2个月前自觉感冒后出现咳嗽,刺激性干咳为主,偶有咳少量白黏痰,昼夜无差异,无发热,无乏力、盗汗,无胸痛、咯血、呼吸困难,无声音嘶哑,无返酸、嗳气,无鼻     

黏膜相关淋巴组织淋巴瘤的临床研究

目的为提高对黏膜相关淋巴组织淋巴瘤（ＭＡＬＴ淋巴瘤）临床特征的认识。方法经我院确诊的ＭＡＬＴ淋巴瘤２４例,进行回顾性的临床分析研究。结果按原发部位可分为胃肠（ＧＩ）和非胃肠（ＮＯＮＧＩ）两组。ＧＩ组１８例（７５０％）,ＮＯＮＧＩ组６例（２５０％）,后者包括涎腺３例、肺２例和膀胱１例。手术治疗２１例,其中单用手术治疗１３例,术后合用化、放疗７例,合用放疗１例。单用化疗３例。随访１７例,失访７例,随访率为７０．８％。生存期４～１２１个月,平均３３个月,中位数１９个月。１７例随访病人中１６例已存活１～１０年,其中存活１年以上者占５８．８％、＞３年以上者占３５．３％、５年以上者占２９．４％、１０年以上者占５．９％。对临床分期和治疗措施与生存率比较显示差异无明显性（Ｐ＞０．０５）。结论ＭＡＬＴ淋巴瘤是非霍奇金淋巴瘤的一种独特亚型,具有起病隐匿、病程长、进展慢及患病率低、好发于中老年男性、Ｂ症状少见、易误诊为假性淋巴瘤、治疗疗效和预后良好等特征。     

胆囊黏膜相关淋巴组织B细胞淋巴瘤1例

患者,女,77岁,因“尿黄,皮肤黄染伴瘙痒半个月”入院,伴白色陶土样便,半个月体质量下降约10 kg．CT和MRCP诊断为胆囊癌、胆道高位梗阻,后经病理确诊为胆囊黏膜相关淋巴组织淋巴瘤(B细胞来源),此病例罕见．     

肺黏膜相关淋巴组织淋巴瘤二例

原发于肺的黏膜相关淋巴组织淋巴瘤（mucosaassociated lymphoid tissue lymphoma，MALTLoma）较少见，现结合有关文献对我院收治的2例患者的临床资料分析报告如下。     

Gastric mucosa-associated lymphoid tissue lymphoma

The connection between Helicobacter pylori and gastric mucosa-associated lymphoid tissue (MALT) lymphoma is well established. H. pylori infection causes an immunological response, leading to chronic gastritis with formation of lymphoid follicles within the stomach. These lymphoid follicles resemble nodal tissues found throughout the body and are composed of reactive T cells and activated plasmal cells and B cells. The B cells are responsible for initiating a clonal expansion of centrocyte-like cells that form the basic histology of MALT lymphoma. Early diagnosis of MALT lymphoma is difficult but essential for adequate treatment. Clinical symptoms are vague and varied, with abdominal pain being a common presenting complaint. The endoscopic appearance of this tumor is varied and can be infiltrative, exophytic, or ulcerative. In addition, the tumor can have a multifocal distribution, and therefore aggressive tissue sampling is crucial for diagnosis. Endoscopic ultrasound is essential to document the extent of disease and is more accurate than CT scan in detection of spread to perigastric lymph nodes. Lesions that are confined to the mucosa or submucosa of the gastric wall are believed to be dependent on H. pylori stimulation and therefore can be successfully treated with H. pylori eradication. Those MALT lymphomas that present at more advanced stages require more aggressive management and can be treated with surgical resection, radiation, or chemotherapy. Follow-up is critical in all patients who have been treated with H. pylori eradication and consists of multiple endoscopic biopsies for histological and molecular studies as well as endoscopic ultrasound at 3, 6, and 12 months after treatment. The reappearance of MALT lymphomas has been seen years after treatment, and therefore follow-up of these patients should be indefinite.     

Clinicopathological features of gastric mucosa-associated lymphoid tissue lymphoma: A comparison with diffuse large B-cell lymphoma without a mucosa-associated lymphoid tissue lymphoma component

BACKGROUND AND AIMS: The aim of this study was to clinicopathologically distinguish the pathogenesis of gastric mucosa-associated lymphoid tissue (MALT) lymphoma and diffuse large B-cell lymphoma without a MALT lymphoma component (DLL). METHODS: We investigated clinicopathological features of these gastric lymphomas including age, sex ratio, tumor location and depth, macroscopic appearance, and infection with Helicobacter pylori of these gastric lymphomas and hepatitis viruses in 24 patients with gastric low-grade MALT lymphoma, 10 patients with high-grade MALT lymphoma, and 19 patients with DLL. The frequency of H. pylori infection in lymphoma patients was compared with that in age- and sex-matched control subjects. RESULTS: There was a predominance of females with MALT lymphoma (male to female ratio, 8/16 for low-grade MALT lymphomas and 1/9 for high-grade MALT lymphomas), and there was a predominance of males with DLL (male to female ratio, 13/6); the ratios differed significantly (P < 0.05). Ninety-two percent of low-grade MALT lymphomas and 80% of high-grade MALT lymphomas were confined to the mucosal and submucosal layers, but lymphoma cells invaded the muscular layer or more deeply in 74% of DLL. Helicobacter pylori infection occurred significantly more often in patients with low-grade MALT lymphoma than in age- and sex-matched controls (96 vs 67%, P < 0.01). Conversely, the frequency of H. pylori infection in DLL patients did not differ from that in controls. CONCLUSIONS: These data suggest that H. pylori infection may be associated with the development of gastric MALT lymphoma, but not DLL, and that MALT lymphoma and DLL may have a different pathogenesis.     

胃黏膜相关淋巴组织淋巴瘤临床与胃镜表现分析

目的探讨胃黏膜相关淋巴组织(mucosa-associated lymphoid tissue,MALT)淋巴瘤临床和内镜下表现特征,提高其在胃镜下的早期诊断率。方法对15例胃MALT淋巴瘤患者临床和内镜下表现特征进行回顾性分析。结果胃MALT淋巴瘤多见于40~60岁患者,男女发病率相近。临床症状无特异性,H.pylori感染率为73.33%。胃MALT淋巴瘤多位于胃窦部,66.67%表现为单个或多个溃疡,质地偏硬,蠕动性及胃腔形态无明显特异性。结论胃MALT淋巴瘤作为一类特殊的原发性胃淋巴瘤,内镜下多块、深而大的活检有助于提高确诊率。     

25例胃肠道黏膜相关淋巴组织淋巴瘤的临床与病理

胃肠黏膜相关淋巴组织淋巴瘤是来源于MALT的胃肠道原发性淋巴瘤, 有特殊的组织学征象,是原发性胃恶性淋巴瘤的主要类型.胃MALT淋巴瘤是结外型非霍奇金淋巴瘤中最常见者,因其在组织学上常有淋巴滤泡和浆细胞出现,与淋巴细胞性胃炎、反应性淋巴细胞增生的组织学相类似,较易引起误诊,现结合我院的25例胃肠淋巴瘤病例的临床与病理,对此做出如下分析.     

胃黏膜相关淋巴组织淋巴瘤临床研究及随访

目的探讨胃黏膜相关淋巴组织淋巴瘤的临床特征及治疗策略。方法采用回顾性方法对32例经组织学确诊的胃黏膜相关淋巴组织淋巴瘤进行随访。结果32例患者中多数起病隐匿，上腹痛为主要症状，也有以消化道出血入院者。内镜下病变主要分布在胃窦部，以隆起型和溃疡型表现为主。首次胃镜检查约25％获正确诊断。本组病例幽门螺杆菌感染率约为88％。20例（62．5％）接受了手术治疗，15例（46．88％）行幽门螺杆菌根除治疗，其中，3例早期阶段患者获得组织学完全缓解。结论胃黏膜相关淋巴组织淋巴瘤的临床表现、内镜下特征和病理特点的认识有待进一步提高。对早期阶段患者幽门螺杆菌治疗当属首选。