Caramaschi P, Biasi D, Carletto A, Ambrosetti A, Mocella S, Randon M, Bambara L M
Dipartimento di Medicina Clinica e Sperimentale, Università, Verona.
Recenti Prog Med. 1999 Nov;90(11):585-91.
We describe a 68-year old woman affected by chronic hepatitis C virus infection; hypertransaminasemia was first observed at the age of 46 years, when the patient was diagnosed uterus carcinoma. Since 1994 she had complained of xerostomia, xerophtalmia, pain at the left parotid and laterocervical adenomegaly. Neck ultrasound examination revealed enlarged intraglandular, submandibular and laterocervical lymph nodes. Fine-needle aspiration of both left parotid and laterocervical lymph nodes was not diagnostic. The histologic examination of the surgical biopsy of the left parotid and the right submandibular salivary gland allowed to diagnose mucosa-associated lymphoid tissue lymphoma (MALT lymphoma). The patient was given alpha-interferon obtaining a clinical remission of the lymphoma and transitory normalization of transaminase level. The authors review the literature about some aspects of MALT lymphomas: a) the etiopathogenesis of MALT lymphomas and the mechanisms suspected to be involved in the evolution from a "benign" lymphoepithelial infiltrate to a neoplastic disorder; b) the relationship between chronic inflammatory diseases as Sjögren's syndrome and chronic C virus infection and MALT lymphomas, particularly MALT lymphomas of the salivary glands; c) the significance of the evidence of a B-cell clonality in the context of a lymphoepithelial lesion; d) diagnostic and therapeutic aspects of MALT lymphomas of the salivary glands.
我们描述了一位68岁患有慢性丙型肝炎病毒感染的女性;高转氨酶血症于46岁首次被发现,当时该患者被诊断为子宫癌。自1994年以来,她一直抱怨有口干、眼干、左腮腺疼痛以及颈侧淋巴结肿大。颈部超声检查显示腺体内、颌下和颈侧淋巴结肿大。对左腮腺和颈侧淋巴结进行细针穿刺活检未能明确诊断。对左腮腺和右颌下唾液腺进行手术活检的组织学检查确诊为黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)。该患者接受了α干扰素治疗,淋巴瘤获得临床缓解,转氨酶水平暂时恢复正常。作者回顾了关于MALT淋巴瘤某些方面的文献:a)MALT淋巴瘤的病因发病机制以及怀疑参与从“良性”淋巴上皮浸润演变为肿瘤性疾病的机制;b)慢性炎症性疾病如干燥综合征和慢性丙型肝炎病毒感染与MALT淋巴瘤,特别是唾液腺MALT淋巴瘤之间的关系;c)在淋巴上皮病变背景下B细胞克隆性证据的意义;d)唾液腺MALT淋巴瘤的诊断和治疗方面。