Nishimura M, Miyajima S, Okada N
Department of Dermatology, Osaka Kosei-nenkin Hospital, Japan.
J Dermatol. 2000 Jul;27(7):450-2. doi: 10.1111/j.1346-8138.2000.tb02204.x.
We report a case of salivary gland MALT lymphoma in Sjögren's syndrome associated with localized H. pylori infection. A 76-year-old woman had a history of bilateral cheek masses for two years. Histologically, the parotid glands were invaded by numerous centrocyte-like cells to form lymphoepithelial lesions. The tumor cells showed immunohistological differentiation into B cells. Southern blotting demonstrated immunoglobulin gene rearrangement. These results indicated that the tumors were MALT lymphoma. H. pylori, as assessed by the urease test (CLO test; BML Ltd., Tokyo, Japan), was positive in the tumor specimen. After wide local excision of the tumors followed by radio therapy and oral administration of antibiotics and proton pump inhibitor, no evidence of recurrence was found during the 24-months of follow up. H. pylori infection in the salivary gland is rare, although the source of infection and transmission of H. pylori organisms has been thought to be the oral cavity. We discussed the association between H. pylori infection and salivary gland MALT lymphoma. The microorganism may play a role as an additional antigenic stimulus for the development of salivary gland MALT lymphoma as well as for the development of gastric MALT lymphoma. This means that H. pylori can play a role in lymphoma progression as booster of B cell lymphoproliferation.
我们报告1例与局限性幽门螺杆菌感染相关的干燥综合征合并涎腺黏膜相关淋巴组织淋巴瘤。一名76岁女性有双侧颊部肿物病史2年。组织学检查显示，腮腺被大量中心细胞样细胞浸润，形成淋巴上皮病变。肿瘤细胞免疫组织化学显示分化为B细胞。Southern印迹法显示免疫球蛋白基因重排。这些结果表明肿瘤为黏膜相关淋巴组织淋巴瘤。通过尿素酶试验（CLO试验；日本东京BML有限公司）评估，肿瘤标本中幽门螺杆菌呈阳性。在对肿瘤进行广泛局部切除，随后进行放射治疗，并口服抗生素和质子泵抑制剂后，随访24个月期间未发现复发迹象。涎腺幽门螺杆菌感染罕见，尽管幽门螺杆菌的感染源和传播途径一直被认为是口腔。我们讨论了幽门螺杆菌感染与涎腺黏膜相关淋巴组织淋巴瘤之间的关联。这种微生物可能作为额外的抗原刺激物，在涎腺黏膜相关淋巴组织淋巴瘤以及胃黏膜相关淋巴组织淋巴瘤的发生发展中发挥作用。这意味着幽门螺杆菌可作为B细胞淋巴增殖的促进剂，在淋巴瘤进展中发挥作用。
