Iida Takeshi, Iwahashi Makoto, Nakamura Masaki, Nakamori Mikihito, Yokoyama Shozo, Tani Masaji, Akamatsu Hiroko, Nakamine Hirokazu, Yamaue Hiroki
Second Department of Surgery, Wakayama Medical University, Wakayama, Japan.
Hepatogastroenterology. 2007 Sep;54(78):1898-901.
Primary marginal zone B-cell lymphoma of mucosa associated tissue (MALT) type in the liver is extremely rare, and the etiology of this disease is yet to be clarified. We present the first report of a primary hepatic low-grade lymphoma of MALT-type associated with Helicobacter pylori (H. pylori) infection. A 64-year-old man was referred to our hospital for the treatment of early gastric carcinoma. He underwent distal gastrectomy with regional lymph node dissection. In the operation, several small nodules were recognized at the surface of the liver, and one of these hepatic nodules was resected as biopsy. The hepatic lesion exhibited a nodular growth pattern consisting of centrocyte-like cells and intermediate lymphocytes, which were stained with CD20 and CD79a, but not with CD43 or CD45RO. The neoplastic cells form lymphoepithelial lesions infiltrating bile ducts. From these findings the liver lesion was diagnosed as marginal zone B-cell lymphoma of MALT type. Histological examinations of resected stomach and residual stomach showed H. pylori infection. There is a strong association between the presence of H. pylori in the stomach and in the bile, and therefore, the H. pylori may be related to the etiology of primary hepatic MALT type lymphoma.
肝脏黏膜相关组织（MALT）型原发性边缘区B细胞淋巴瘤极为罕见，该病的病因尚待阐明。我们首次报告了一例与幽门螺杆菌（H. pylori）感染相关的原发性肝脏MALT型低度淋巴瘤。一名64岁男性因早期胃癌前来我院治疗。他接受了远端胃切除术及区域淋巴结清扫术。术中在肝脏表面发现了几个小结节，其中一个肝脏结节被切除作为活检样本。肝脏病变呈现结节状生长模式，由中心细胞样细胞和中等大小淋巴细胞组成，这些细胞CD20和CD79a染色阳性，但CD43或CD45RO染色阴性。肿瘤细胞形成浸润胆管的淋巴上皮病变。根据这些发现，肝脏病变被诊断为MALT型边缘区B细胞淋巴瘤。对切除的胃和残余胃进行组织学检查显示有幽门螺杆菌感染。胃和胆汁中均存在幽门螺杆菌，二者之间存在密切关联，因此，幽门螺杆菌可能与原发性肝脏MALT型淋巴瘤的病因有关。
