Shim Chan Sup, Lee Joon Seong, Kim Jin Oh, Cho Joo Young, Lee Moon Sung, Jin So Young, Youm Wook
Institute for Digestive Research, Digestive Disease Center, College of Medicine, Soon Chun Hyang University, 657 Hannam-dong, Yongsan-gu, Seoul 140-743, Korea.
J Korean Med Sci. 2003 Feb;18(1):120-4. doi: 10.3346/jkms.2003.18.1.120.
The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.
原发性食管淋巴瘤极为罕见，具有多种形态学特征。文献中仅报道过1例局限于食管的黏膜相关淋巴组织（MALT）型淋巴瘤。一名61岁男性因内镜检查偶然发现食管黏膜下肿瘤（SMT）而转诊至我院。他15年前有肺结核病史并长期服用抗结核药物，1年前有梅毒病史且已接受治疗。因自身免疫性甲状腺炎，他在过去10个月一直在服用合成甲状腺激素。内镜检查显示一个纵向圆形管状的光滑隆起病变，表面黏膜完整，位于食管中下段，距门齿31 cm至39 cm处。内镜超声检查（EUS）显示一个巨大的纵向生长的中低回声肿块，位于黏膜下层，内部有大小不一的小蜂窝状无回声病变，提示生发中心。随后，他接受了手术，病理证实该肿块为原发性食管MALT型低级别B细胞淋巴瘤。
