El-Hawary Amira Kamal
The Department of Pathology, Faculty of Medicine, Mansoura University. amira
J Egypt Natl Canc Inst. 2006 Jun;18(2):103-8.
MALT lymphoma arises in a variety of body tissues, but most often in the stomach. Though relatively rare, these MALT lymphomas may arise within several sites in the head and neck, and often present diagnostic and therapeutic challenges. Immunohistochemical analysis are helpful in confirming the diagnosis between the MALT-lymphoma and the reactive lymphoid hyperplasia. MALT-type lymphoma demonstrated characteristic negative staining for CD3, CD5 and CD43, positive staining for CD20, and monotypic staining for either kappa or lambda light chain immunoglobulin markers, whereas reactive lymphoid hyperplasia all expressed B and T cell markers.
41 Cases of nasopharyngeal masses were obtained from the files at pathology department, Mansoura Faculty of Medicine through the period from 2002 till 2006. 31 cases were corresponded histomorphologically to low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type and 10 patients with reactive lymphoid hyperplasia of the adenoid. Hematoxylin- eosin-stained slides were reviewed to confirm the diagnosis. Immunohistochemical studies were performed on formalin-fixed, paraffin-embedded sections using the labeled streptavidin-biotin-peroxidase complex method with DAB as chromogen. The following antibodies were evaluated CD20, CD3, Kappa, lambda and cytokeratin antibodies.
All cases of low grade MALT lymphoma show lymphoepithelial lesion and proliferation of centrocyte like cells. 14 cases (45.1%) show subepithelial plasma cells. Dutcher bodies were demonstrated in 10 cases (32.2%). Monocytoid B-cells were seen in 12 cases (38.7%). Six (60%) out of the ten cases of adenoids show transmigrating lymphocyte without formation of lymphoepithelial lesion. All cases with MALT-type lymphoma expressed CD20 and not CD3 whereas 10 cases of adenoid, all expressed B and T cell markers. Immunohistochemical staining showed that 31 cases of low grade MALT lymphoma were positive for immunoglobin light chain (kappa or lambda) while 10 cases of adenoid were positive for both kappa and lambda light chain.
Immunohistochemical analysis are helpful in confirming the diagnosis between the MALT-lymphoma and the reactive lymphoid hyperplasia of the nasopharynx.
黏膜相关淋巴组织边缘区淋巴瘤（MALT淋巴瘤）可发生于多种身体组织，但最常见于胃部。尽管相对罕见，但这些MALT淋巴瘤可发生于头颈部的多个部位，常带来诊断和治疗方面的挑战。免疫组织化学分析有助于鉴别MALT淋巴瘤与反应性淋巴组织增生。MALT型淋巴瘤表现为CD3、CD5和CD43特征性阴性染色，CD20阳性染色，以及κ或λ轻链免疫球蛋白标志物单克隆染色，而反应性淋巴组织增生均表达B和T细胞标志物。
从曼苏拉医学院病理科档案中获取2002年至2006年期间的41例鼻咽部肿物病例。其中31例组织形态学符合黏膜相关淋巴组织（MALT）型低度B细胞淋巴瘤，10例为腺样体反应性淋巴组织增生。复查苏木精-伊红染色切片以确诊。采用标记链霉亲和素-生物素-过氧化物酶复合物法，以DAB作为显色剂，对福尔马林固定、石蜡包埋切片进行免疫组织化学研究。评估以下抗体：CD20、CD3、κ、λ和细胞角蛋白抗体。
所有低度MALT淋巴瘤病例均显示淋巴上皮病变和中心细胞样细胞增殖。14例（45.1%）显示上皮下浆细胞。10例（32.2%）可见杜氏小体。12例（38.7%）可见单核样B细胞。10例腺样体病例中有6例（60%）显示淋巴细胞迁移但未形成淋巴上皮病变。所有MALT型淋巴瘤病例均表达CD20而不表达CD3，而10例腺样体病例均表达B和T细胞标志物。免疫组织化学染色显示，31例低度MALT淋巴瘤病例免疫球蛋白轻链（κ或λ）阳性，而10例腺样体病例κ和λ轻链均阳性。
免疫组织化学分析有助于鉴别鼻咽部MALT淋巴瘤与反应性淋巴组织增生。
