Departments of Pathology and Internal Medicine, Faculty of Medicine, Fukuoka University, Nanakuma 7-45-1, Johnan-ku, Fukuoka, Japan.
Virchows Arch. 2012 Apr;460(4):379-87. doi: 10.1007/s00428-012-1199-x. Epub 2012 Mar 7.
Sixty-four cases of malignant lymphoma involving the liver were examined. Of these, 20 cases were histologically confirmed to be primary hepatic B-cell lymphoma. Twelve of these 20 cases were diffuse large B-cell lymphoma (DLBCL) and eight cases were mucosa-associated lymphoid tissue (MALT) lymphoma. Of the 12 cases of DLBCL, six were immunohistologically positive for CD10 and/or Bcl6 (indicating a germinal center phenotype), six were positive for Bcl2, and five were positive for CD25. Eight of the 12 DLBCL cases (66.7%) and two of the eight MALT lymphoma cases (25%) had serum anti-hepatitis C virus (HCV) antibodies and HCV RNA. The incidence of HCV infection was significantly higher in the hepatic DLBCL cases than in systemic intravascular large B-cell cases with liver involvement (one of 11 cases, 9.1%) and T/NK-cell lymphoma cases (one of 19 cases, 5.3%) (p < 0.01 for both). Two hepatic DLBCL cases (16.7%) had rheumatoid arthritis treated with methotrexate, and four MALT lymphoma cases (50%) had Sjögren's syndrome, primary biliary cirrhosis, or autoimmune hepatitis; one case in each of these two groups was complicated by chronic HCV-seropositive hepatitis. Although primary hepatic lymphoma is rare, persistent inflammatory processes associated with HCV infection or autoimmune disease may play independent roles in the lymphomagenesis of hepatic B cells.
我们研究了 64 例肝恶性淋巴瘤病例。其中 20 例经组织学证实为原发性肝 B 细胞淋巴瘤。这 20 例中，12 例为弥漫性大 B 细胞淋巴瘤（DLBCL），8 例为黏膜相关淋巴组织（MALT）淋巴瘤。12 例 DLBCL 中，6 例免疫组织化学 CD10 和/或 Bcl6 阳性（提示生发中心表型），6 例 Bcl2 阳性，5 例 CD25 阳性。12 例 DLBCL 中有 8 例（66.7%）和 8 例 MALT 淋巴瘤中有 2 例（25%）血清抗丙型肝炎病毒（HCV）抗体和 HCV RNA 阳性。肝 DLBCL 病例 HCV 感染的发生率明显高于伴有肝受累的系统性血管内大 B 细胞病例（11 例中的 1 例，9.1%）和 T/NK 细胞淋巴瘤病例（19 例中的 1 例，5.3%）（均 p<0.01）。2 例肝 DLBCL （16.7%）因类风湿关节炎接受甲氨蝶呤治疗，4 例 MALT 淋巴瘤（50%）患有干燥综合征、原发性胆汁性肝硬化或自身免疫性肝炎；这两组各有 1 例合并慢性 HCV 血清阳性肝炎。尽管原发性肝淋巴瘤罕见，但与 HCV 感染或自身免疫性疾病相关的持续炎症过程可能在肝 B 细胞淋巴瘤的发生中起独立作用。
