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非胃肠道非眼部结外黏膜相关淋巴组织(ENMALT)边缘区淋巴瘤的临床特征与管理

Clinical features and management of non-gastrointestinal non-ocular extranodal mucosa associated lymphoid tissue (ENMALT) marginal zone lymphomas.

作者信息

Matutes Estella, Montalban Carlos

机构信息

Hematopathology Unit, Hospital Clínic, Barcelona, Spain.

Department of Hematology, MD Anderson Cancer Center, Madrid, Spain.

出版信息

Best Pract Res Clin Haematol. 2017 Mar-Jun;30(1-2):99-108. doi: 10.1016/j.beha.2016.07.005. Epub 2016 Nov 5.

Abstract

Extranodal mucosa associated lymphoid tissue (ENMALT) marginal zone lymphomas may arise at any site of the body. The most frequent localizations other than gastrointestinal and eye are salivary gland, skin, lung and thyroid. These lymphomas usually arise in a setting of inflammation due to a persistent infection or autoimmune diseases such as Sjogren syndrome in salivary MALT lymphomas and Hashimoto's thryroiditis in thyroid lymphomas. They affect middle-aged patients with a female predominance when lymphoma arises in certain locations. Patients often present with localised stage I or II although disseminated disease may be present at diagnosis or relapse in a third of the cases. Biopsy of the affected site is mandatory to establish the diagnosis and a full work-up staging is recommended. The clinical course is indolent and prognosis is good despite that recurrences following response to therapy are frequent. Surgery, radiotherapy and/or Rituximab based regimens are effective in these lymphomas.

摘要

结外黏膜相关淋巴组织(ENMALT)边缘区淋巴瘤可发生于身体的任何部位。除胃肠道和眼部外,最常见的发病部位是唾液腺、皮肤、肺和甲状腺。这些淋巴瘤通常在持续性感染或自身免疫性疾病(如唾液腺MALT淋巴瘤中的干燥综合征和甲状腺淋巴瘤中的桥本甲状腺炎)所致的炎症背景下发生。当淋巴瘤在某些部位发生时,发病年龄多为中年,女性为主。患者常表现为局限性的I期或II期,不过在三分之一的病例中,诊断时或复发时可能已有播散性疾病。必须对受累部位进行活检以明确诊断,建议进行全面的分期检查。临床过程呈惰性,尽管治疗后复发频繁,但预后良好。手术、放疗和/或基于利妥昔单抗的方案对这些淋巴瘤有效。

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