Piña-Oviedo Sergio, Ortiz-Hidalgo Carlos
Departamento de Biología Celular y Tisular, Escuela de Medicina, Universidad Panamericana, México, DF, México.
Gac Med Mex. 2007 May-Jun;143(3):237-44.
Significant advances in the understanding of marginal zone lymphoma since the first description in 1983 by Peter Isaacson and Dennis Wright have been noted. MALT lymphomas are a subgroup of low-grade B-cell lymphomas that arise from extranodal sites, comprising 7-8% of all B-cell lymphomas and displaying distinct clinicopathological characteristics. MALT lymphomas remain localized in the primary site for long periods of time and seldom disseminate unto other organs. These type of lymphomas infrequently arise in native MALT, but instead arise in MALT acquired in the course of chronic inflammatory disorders, such as Sjögren's syndrome and Helicobacter pylori infection. Eradication of H. pylori produces a clinical regression of the lymphoma in about 75% of cases. The histological hallmarks of MALT lymphoma include neoplastic centrocyte-like B cells, cells resembling monocytoid cells and the presence of lymphoepithelial lesions. The gastrointestinal tract, particularly the stomach, include two-thirds of cases; however MALT lymphomas also occur in other organs such as salivary glands, lung, thyroid, ocular adnexa, breast and skin. Genetic studies have identified three chromosomal translocations specifically associated with MALT lymphomas that include: t(1l:18)(q21;q21), t(1;14)(p22;q32), and t(14;18)(q32;q21). Although these translocations involve different genes, they appear to share a common oncogenic pathway involving NFkappaB.
自1983年彼得·艾萨克森和丹尼斯·赖特首次描述边缘区淋巴瘤以来,在对其的认识上已取得了显著进展。黏膜相关淋巴组织淋巴瘤(MALT淋巴瘤)是起源于结外部位的低度B细胞淋巴瘤的一个亚组,占所有B细胞淋巴瘤的7 - 8%,并表现出独特的临床病理特征。MALT淋巴瘤长时间局限于原发部位,很少扩散至其他器官。这类淋巴瘤很少起源于天然的黏膜相关淋巴组织,而是起源于慢性炎症性疾病过程中获得的黏膜相关淋巴组织,如干燥综合征和幽门螺杆菌感染。根除幽门螺杆菌可使约75%的病例中的淋巴瘤出现临床消退。MALT淋巴瘤的组织学特征包括肿瘤性中心细胞样B细胞、类似单核细胞样的细胞以及淋巴上皮病变的存在。胃肠道,尤其是胃,占病例的三分之二;然而,MALT淋巴瘤也发生于其他器官,如唾液腺、肺、甲状腺、眼附属器、乳腺和皮肤。遗传学研究已确定了三种与MALT淋巴瘤特异性相关的染色体易位,包括:t(11;18)(q21;q21)、t(1;14)(p22;q32)和t(14;18)(q32;q21)。尽管这些易位涉及不同的基因,但它们似乎共享一条涉及核因子κB的共同致癌途径。