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目的:探讨原发性肺黏膜相关淋巴瘤的临床特征、诊断、鉴别诊断及治疗。方法:报告1例肺黏膜相关淋巴瘤患者的临床资料、影像学表现、实验室检查和治疗、随访情况,复习国内外相关文献5篇。结果:原发性肺黏膜相关性淋巴组织淋巴瘤是抗原长期刺激,发生免疫应答及局部炎症,从无到有产生淋巴组织、淋巴细胞免疫性增殖,从良性转化为恶性,出现异常克隆而导致黏膜相关淋巴组织淋巴瘤,属于结外非霍奇金淋巴瘤。病理免疫组化特点:若κ和λ两种轻链同时染色,为多克隆性,通常提示病变的组织为良性反应性增生;若病灶细胞的免疫球蛋白仅有一种轻链(κ或λ)染色阳性,即单克隆性,则见于原发性肺低度恶性B细胞淋巴瘤。肺黏膜相关淋巴组织淋巴瘤CD20(+)。结论:原发性肺黏膜相关淋巴瘤大多属低度恶性,发展缓慢,早期不易浸润至远处部位,手术切除彻底,术后化疗效果好。需与肺的恶性肿瘤、淋巴细胞间质肺炎、淋巴瘤样肉芽肿、隐球菌性肺炎等相鉴别。
Objective: To investigate the clinical features, diagnosis, differential diagnosis and treatment of primary pulmonary mucosa-associated lymphoma. Methods: The clinical data, imaging findings, laboratory tests, treatment and follow-up of one patient with pulmonary mucosa-associated lymphoma were reviewed. Five articles were reviewed at home and abroad. RESULTS: Primary pulmonary mucosa-associated lymphoid tissue lymphoma was a long-term antigen-induced immune response and local inflammation. Lymphoid tissue and lymphocyte immune proliferation occurred from scratch, from benign to malignant and abnormal clones Mucosa-associated lymphoid tissue lymphoma belongs to the extranodal non-Hodgkin’s lymphoma. Pathological immunohistochemical features: If both kappa and lambda light chain staining at the same time, polyclonal, usually prompted lesions of benign reactive hyperplasia; if the focal cell immunoglobulin only a light chain (κ or λ) Dyeing positive, that is, monoclonal, then found in primary lung low grade B-cell lymphoma. Pulmonary mucosa associated lymphoid tissue lymphoma CD20 (+). Conclusion: Most of the primary pulmonary mucosa-associated lymphomas are of low grade and develop slowly. They are not easily infiltrated to distant sites in the early stage. The surgical resection is complete and the postoperative chemotherapy is effective. Malignant neoplasms with lung cancer, lymphocytic leukemia, lymphoma-like granuloma, cryptococcal pneumonia and other phase identification.