原发胸膜黏膜相关淋巴组织边缘区淋巴瘤临床病理特征分析  

Clinicopathological characteristics of primary pleural extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue

作　　者：胡秀梅[1] 李雪[1] 路军[1] 刁小莉[1] 田忠秋 赵宏颖[1] 金木兰[1] HU Xiu-mei;LI Xue;LU Jun;DIAO Xiao-li;TIAN Zhong-qiu;ZHAO Hong-ying;JIN Mu-lan(Department of Pathology,Beijing Chaoyang Hospital,Capital Medical University,Beijinɡ100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《诊断病理学杂志》2023年第4期345-348,368,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨原发胸膜黏膜相关淋巴组织边缘区淋巴瘤(MALT淋巴瘤)的临床病理学特征。方法收集首都医科大学附属北京朝阳医院病理科2014-02—2018-12诊断的原发胸膜MALT淋巴瘤6例,分析临床特征、影像学资料、组织形态学特点,应用免疫组化方法检测相关指标表达情况,并行Ig基因克隆性重排检测。结果6例原发胸膜MALT淋巴瘤中,男性3例,女性3例,年龄范围为58~78岁;均因呼吸系统症状而就诊;5例为单侧胸腔积液,1例为双侧胸腔积液;胸腔镜下见胸膜增厚或结节形成;组织学形态为小至中等大小的淋巴样细胞弥漫片状分布,间皮细胞及纤维组织未见增生或轻度增生;免疫染色结果与其他常见部位MALT淋巴瘤基本一致;6例中有5例Ig基因克隆性重排,1例阴性。6例中有1例获得随访,患者确诊40个月后死亡,余5例失访。结论胸膜是MALT淋巴瘤的罕见部位,诊断困难,综合临床病史、组织学形态、免疫表型,必要时补充基因检测,可做出正确诊断。Objective To investigate the clinicopathological characteristics of primary pleural extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT lymphoma).Methods A total of 6 cases of primary pleural MALT lymphoma diagnosed in Department of Pathology,Beijing Chaoyang Hospital,Capital Medical University from February 2014 to December 2018 were retrospectively analyzed.The clinical features,imaging data and histomorphological characteristics were analyzed.Immunohistochemistry was used to detect the expression of related indicators.Clonal rearrangement of Ig gene was detected.Results Of the 6 cases of primary pleural MALT lymphoma,3 were male and 3 were female,ranging in age from 58 to 78 years.All were seen for respiratory symptoms.5 patients presented with unilateral pleural effusion and 1 with bilateral pleural effusion.Thoracoscopy showed pleural thickening or nodule formation.Histologically,medium to small lymphoid cells were found in fibrous tissue and adipose tissue,mainly small lymphocytelike cells.No significant or only mild hyperplasia was observed in mesothelial cells and fibrous tissue.The immunostaining results were basically consistent with those of MALT lymphoma in other common sites.Among the 6 cases,5 cases were positive and 1 case was negative for Ig gene clonal rearrangement.One of the six patients was followed up and died 40 months after diagnosis.Conclusion Pleura is a rare site of MALT lymphoma,which is difficult to diagnose.A correct diagnosis can be made by combining the clinical history,histological morphology,immunophenotype and gene testing if necessary.

关 键 词：胸膜 淋巴瘤 临床病理学特征 诊断 

分 类 号：R73[医药卫生—肿瘤]