Hew W S R, Carey F A, Kernohan N M, Heppleston A D, Jackson R, Jarrett R F
Department of Pathology, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK.
J Clin Pathol. 2002 Jan;55(1):61-3. doi: 10.1136/jcp.55.1.61.
Lymphoma of the salivary gland accounts for 5% of cases of extranodal lymphoma and 10% of malignant salivary gland tumours. Most primary salivary gland lymphomas are B marginal zone lymphomas arising on a background of sialadenitis associated with autoimmune disorders such as Sjorgen's syndrome. Primary T cell lymphoma of the salivary gland is rare. This report describes a case of primary T cell lymphoma arising in the parotid gland of an elderly white man, which was notable for its striking resemblance to a B cell extranodal marginal zone lymphoma. Immunohistochemistry and gene rearrangement studies confirmed the clonal T cell nature of the tumour. There was no molecular evidence of Epstein-Barr virus (EBV) infection of neoplastic or surroundings cells. Only 14 cases of primary T cell lymphoma of the salivary glands have been recorded in the literature, most being from the Orient and having extremely variable prognosis. Those with a T/natural killer cell phenotype are associated with EBV infection. This case highlights the fact that T cell lymphoma in the salivary gland can mimic closely the morphological features of B cell extranodal marginal zone lymphoma.
涎腺淋巴瘤占结外淋巴瘤病例的5%,占涎腺恶性肿瘤的10%。大多数原发性涎腺淋巴瘤是B细胞边缘区淋巴瘤,发生于与自身免疫性疾病(如干燥综合征)相关的涎腺炎背景之上。原发性涎腺T细胞淋巴瘤较为罕见。本报告描述了一例发生于一位老年白人男性腮腺的原发性T细胞淋巴瘤病例,该病例因其与B细胞结外边缘区淋巴瘤极为相似而引人注目。免疫组织化学和基因重排研究证实了肿瘤的克隆性T细胞性质。没有分子证据表明肿瘤细胞或周围细胞存在爱泼斯坦-巴尔病毒(EBV)感染。文献中仅记录了14例涎腺原发性T细胞淋巴瘤病例,大多数来自东方,预后差异极大。具有T/自然杀伤细胞表型的病例与EBV感染相关。该病例凸显了涎腺T细胞淋巴瘤可紧密模仿B细胞结外边缘区淋巴瘤形态学特征这一事实。