Iyengar Pratibha, Deodhare Sanjeev
Department of Pathology, Sunnybrook and Women's College Health Sciences Center, Toronto, Ontario, Canada.
Gynecol Oncol. 2004 Apr;93(1):238-41. doi: 10.1016/j.ygyno.2004.01.011.
Only one case of primary extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) of the endometrium has been previously reported.
A 65-year old patient presented with postmenopausal bleeding. She was found to have endometrial polyps. The endometrial curettings showed a dense lymphoid infiltrate that was suggestive of a lymphoproliferative disorder. Histological examination of the total abdominal hysterectomy revealed primary extranodal marginal zone B-cell lymphoma (MALT-type lymphoma) of the endometrium. The diagnosis was supported by morphology, immunohistochemistry, and molecular analysis.
Extranodal MALT lymphoma of the endometrium is exceptionally rare although the female genital tract is rich in mucosa and the presence of MALT tissue has been previously described. The diagnosis of lymphoproliferative disorder in this case was initially made on endometrial curettings. Although most lymphoid aggregates within endometrial curettings are due to reactive conditions such as endometritis, the possibility of lymphoma must be kept in mind when dense lymphoid aggregates or atypical lymphoid cells are present in the curettings.
此前仅报道过一例子宫内膜黏膜相关淋巴组织(MALT)原发性结外边缘区B细胞淋巴瘤。
一名65岁患者出现绝经后出血。她被发现患有子宫内膜息肉。子宫内膜刮除物显示密集的淋巴细胞浸润,提示存在淋巴增殖性疾病。全腹子宫切除术的组织学检查显示为子宫内膜原发性结外边缘区B细胞淋巴瘤(MALT型淋巴瘤)。形态学、免疫组织化学和分子分析均支持该诊断。
尽管女性生殖道富含黏膜且此前已描述过MALT组织的存在,但子宫内膜结外MALT淋巴瘤极为罕见。该病例中淋巴增殖性疾病的诊断最初基于子宫内膜刮除物。尽管子宫内膜刮除物中的大多数淋巴聚集是由诸如子宫内膜炎等反应性情况引起的,但当刮除物中存在密集的淋巴聚集或非典型淋巴细胞时,必须考虑淋巴瘤的可能性。