肝黏膜相关淋巴组织型结外边缘区B细胞淋巴瘤临床病理观察  

Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type of the liver:a clinicopathological observation

作　　者：胡余昌[1] 陈路[1] 唐万英[1] 张兆祥[1] 罗代珍[2] 郎博娟[2] 

机构地区：[1]三峡大学第一临床医学院,宜昌443003 [2]湖北省宜昌市中心人民医院病理科,宜昌443003

出　　处：《华中医学杂志》2008年第2期120-122,共3页Central China Medical Journal

摘　　要：目的探讨肝黏膜相关淋巴组织型结外边缘区B细胞淋巴瘤(MALT-MZL)的临床病理学特征、诊断、鉴别诊断和预后。方法对肝MALT-MZL进行病理形态学及免疫组化研究并复习相关文献,分析其临床病理学特征。结果肝MALT-MZL表现为大小不等的结节,最大者3cm×2.5cm×2cm。肿瘤细胞主要由弥漫分布的中心细胞样细胞组成,与肝实质分界清楚。瘤组织内可见残留的小胆管,但未见"淋巴上皮病变"。瘤细胞免疫表型CD20、CD79α和κ呈阳性表达,CD3、CD45RO、CD5、CD10、CyclinD1、λ和bcl-2呈阴性表达。结论肝MALT-MZL是一种罕见的肿瘤,其诊断需要结合病理组织形态及免疫表型,并需与肝其它类型的原发性非霍奇金淋巴瘤及肝脏炎性假瘤等鉴别。Objective To investigate the clinicopathologic charactenstics, differential diagnosis and prognosis of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue type（MALT-MZL）of the liver. Methods A case of MALT-MZL of the liver was studied by histology and immunohistochemistry and review of the literature, and its clinicopathologic charactenstics were analyzed. Results MALT-MZL of liver usually occured in adult. The liver had a variable solid nodules, the greatest one measuring 3 cm × 2. 5 cm × 2 cm. The tumor cells were medium in size and showed diffuse and monotonous infiltration of typical centrocyte-like cells, which were well delineated from the liver parenchyma. Although there were small sized bile ducts within the tumor, apparent lymph-epithelial lesions were not identified. The immunophenotype of the tumor cells was positive for CD20, CD79α, κ and negative for CD3, CD45RO, CD5, CD10, Cyclin D1 ,λ,bcl-2. Conclusion MALT-MZL of the liver is very rare, and the diagnosis needs to combine pathomophology and immunophenotype, eliminating the possibility of other primary non-Hodgkin＇s lymphomas and inflammatory pesudotumors of livers as well.

关 键 词：肝 非霍奇金淋巴瘤 黏膜相关淋巴组织型 

分 类 号：R735.7[医药卫生—肿瘤]