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1、胃腸MALT淋巴瘤臨床及病理分析【摘要】廿的觀察胃腸道粘膜相關(guān)淋巴組織結(jié)外邊緣區(qū)B細(xì)胞淋巴瘤(MALT淋巴瘤)臨床和病理特點(diǎn)。方法收集整理中山大學(xué)附屬第二醫(yī)院2000年1月?2006年12月間的MALT淋巴瘤的臨床資料,通過光鏡和免疫紐化染色進(jìn)行病理纟I[織學(xué)觀察。結(jié)果29例MALT淋巴瘤中,多發(fā)生于胃,臨床主要表現(xiàn)為胃腸道疾病非特異性癥狀。鏡下主要由小淋巴細(xì)胞組成,可伴有少量大細(xì)胞和淋巴上皮樣病變。瘤細(xì)胞表達(dá)B淋巴細(xì)胞免疫標(biāo)記:CD20和CD79a,部分病例表達(dá)CD43和bcl?2°結(jié)論胃腸道MALT淋巴瘤好發(fā)于胃,臨床癥狀無特異
2、性,通過常規(guī)病理檢查和免疫組化染色對(duì)以確診?!娟P(guān)鍵詞】B細(xì)胞淋巴瘤;病理學(xué);免疫組織化學(xué)ClinicalandpathologicalanalysisofB-lymphotumorinoutermarginareaofgastrointestinalmucosa–relatedlymphonodes.WANGLi-li,WANGLin,ZENGYun-jie,etal.TheSecondAffiliatedHospitalofSunYat-senUniversity,Guangzhou510120,Guangdong,P
3、.R.ChinaAbstract:ObjectiveToobservetheclinicalandpathologicalfeaturesofextranodalmarginalzoneB-celloflymphomasmucosa-associatedlymphoidtissue(MALTlymphoma)ingastrointestinaltract,byretrospectivereviewandanalysis.MethodsClincicalandpathologicaldataoflymphomasingastroint
4、estinaltractofpatientsinSecondAffiliatedHospitalofSunYat-senUniversityfrom2000to2006werecollectedandanalyzedbyhematoxylin-eosinstainandimmunohistochemicalstain.ResultsOfallthe29casesofMALTlymphomaingastrointestinaltract,mostcasesoccurredinstomachandtheclinicalmanitesta
5、tionswerenon-specificsymptomsofgastroentericdiseases.Micoroscopically,MALTlymphomamainlyconsistedofsmallcells,accompaniedwithsomelargecellsandlymphoepitheliallesionsinsomecases.ThelymphomacellswerepositiveforBlymphocytemarkers,CD29andCD79α,somealsopositiveforCD43
6、andbcl-2.ConclusionGastricMALTlymphomasarethemostcommononesamongMALTlymphomas.SymptomsofMALTlymphomasarenon-specific.MALTlymphomascanbediagnosedbycombinationofhistopathologywithimmunohistochemistry.Keywords:B-celllymphomas;Gastrointestinaltract;Pathology;Immunohistoche
7、mistry胃腸粘膜相關(guān)淋巴紐織結(jié)外邊緣區(qū)B細(xì)胞淋巴瘤(Mucosa-associatedlymphoidtissuelymphoma,MALT淋巴瘤)是來源于結(jié)外邊緣區(qū)B細(xì)胞的一?類淋巴瘤,其發(fā)生率占非霍奇金淋巴瘤的8%,山成熟不表達(dá)CD5和CD10的B細(xì)胞紐成。常見的發(fā)生部位有胃、腸、涎腺、甲狀腺、肺和眼附屬器[1]。IffMAET淋巴瘤瘤細(xì)胞表達(dá)歸巢受體α4β7,與粘膜組織表達(dá)的地址>MAdCAM-l相作用可使瘤細(xì)胞長期局限于粘膜組織,因而具有較好的預(yù)后[2]。盡管MALT淋巴瘤的具體發(fā)牛機(jī)制還不清楚,但
8、H前普遍認(rèn)為與慢性炎癥刺激和口身免疫性疾病相關(guān),如:Hp相關(guān)性胃炎、小腸粘膜組織彎曲菌感染、Sjogren綜合征、Hashimoto甲狀腺炎和眼鸚鵡熱衣原體感染[3]。其他可能相關(guān)的因素還包括:飲食、環(huán)境、精神心理等。本文中對(duì)胃腸道M