Eck M, Fischbach W
Institut für Pathologie, Klinikum Aschaffenburg, Am Hasenkopf 63704, Aschaffenburg.
Pathologe. 2010 May;31(3):188-94. doi: 10.1007/s00292-009-1269-2.
Helicobacter pylori infection plays a central role in the development of gastric MALT-type (mucosa-associated lymphoid tissue) lymphoma. Infection results in chronic H. pylori gastritis and stimulates together with antigens or autoantigens proliferation of B-lymphocytes which is the basis for the neoplastic transformation. Histology of MALT-type lymphoma is architecturally similar to the physiological MALT. Invasion and destruction of the gastric epithelium with development of so-called lympho-epithelial lesions is the most important diagnostic criterion. Cytologically MALT-lymphoma resembles centrocytes and monocytes. For definitive lymphoma diagnosis and for the differential diagnosis from other small cell lymphomas in the stomach immunohistochemistry can be helpful. The phenotype of MALT-type lymphoma is identical to non-neoplastic B-lymphocytes of the marginal zone (CD20+, CD5-, CD10- and CD23-). Individual therapy is strongly dependent from histological type and lymphoma stadium. Therapy modalities are H. pylori eradication, radiochemotherapy, surgery or a combination of these. Aim of the therapy is the complete lymphoma regression and cure of the disease.
幽门螺杆菌感染在胃黏膜相关淋巴组织（MALT）型淋巴瘤的发生发展中起核心作用。感染导致慢性幽门螺杆菌胃炎，并与抗原或自身抗原一起刺激B淋巴细胞增殖，这是肿瘤转化的基础。MALT型淋巴瘤的组织学结构在结构上与生理性MALT相似。胃上皮的浸润和破坏以及所谓淋巴上皮病变的发展是最重要的诊断标准。在细胞学上，MALT淋巴瘤类似于中心细胞和单核细胞。对于明确淋巴瘤诊断以及与胃内其他小细胞淋巴瘤进行鉴别诊断，免疫组织化学可能会有帮助。MALT型淋巴瘤的表型与边缘区的非肿瘤性B淋巴细胞相同（CD20 +、CD5 -、CD10 - 和CD23 -）。个体化治疗很大程度上取决于组织学类型和淋巴瘤分期。治疗方式包括根除幽门螺杆菌、放化疗、手术或这些方法的联合应用。治疗的目的是使淋巴瘤完全消退并治愈疾病。
