眼附属器黏膜相关淋巴组织型淋巴瘤和反应性淋巴组织增生的鉴别诊断研究

目的　探讨诊断和鉴别诊断眼附属器黏膜相关淋巴组织 (MALT)型淋巴瘤和淋巴组织反应性增生的方法。方法　对 2 9例眼附属器MALT淋巴瘤和 8例淋巴组织反应性增生进行临床、形态学、免疫组化和分子生物学的研究。结果　 2 9例眼附属器MALT淋巴瘤和 8例淋巴组织反应性增生的临床表现相似 ,差异无显著意义。在病理学的诊断中 ,2 9例眼附属器MALT淋巴瘤全部表达B细胞标记 ,不表达T细胞标记 ;免疫球蛋白轻链κ或λ限制 1 1例 ;PCR检测单克隆增生 1 5例 ,无特异表达 1 4例。 8例淋巴组织反应性增生中 ,7例同时表达B细胞标记和T细胞标记 ,且T细胞标记 >30 %;κ和λ阴性 ;PCR检测呈多克隆增生。结论　在眼附属器MALT型淋巴瘤和淋巴组织反应性增生的鉴别诊断中 ,免疫组化和分子生物学技术有助于进一步明确诊断。

Study on differential diagnosis between MALT-type lymphoma and reactive lymphoid hyperplasia of the ocular adnexa

OBJECTIVE: To study the methods of differential diagnosis between mucosa-associated lymphoid tissue (MALT) type lymphoma and reactive lymphoid hyperplasia in ocular adnexa. METHODS: The clinical, morphologic, immunohistochemical, and molecular biologic (polymerase chain reaction [PCR]) studies were performed on 29 patients with MALT-type lymphoma and 8 patients with reactive lymphoid hyperplasia of the ocular adnexa. RESULTS: 29 cases with MALT-type lymphoma expressed B-cell markers and but T-cell makers, whereas 8 cases of reactive lymphoid hyperplasia all expressed B and T cell markers and the positive rate of T-cell marker was up to 30%. immunohistochemistry staining showed 11 cases were positive for immunoglobin light chain (kappa or lambda), however it was positive in one chain of the immunoglobin in 15 cases of MALT type lymphoma by PCR. No significant difference in the clinical characteristics was observed between the MALT type lymphoma and reactive lymphoid hyperplasia in ocular adnexa. CONCLUSION: Immunohistochemical analysis and PCR are helpful in confirming the diagnosis between the MALT-lymphoma and the reactive lymphoid hyperplasia.