Sawada Takahiro, Kitajima Hiromoto, Moribuchi Hayato, Sanada Sakiko, Sueyasu Yoshiko, Iwasaki Akinori
Department of General Thoracic Surgery, Fukuoka Higashi Medical Center, Koga, Japan.
Kyobu Geka. 2018 Nov;71(12):1013-1017.
Pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma is associated with pre-existing infections or autoimmune disorders. We report a case of lung cancer initially suspected of MALT lymphoma. The patient was a 73-year-old woman. Complete screening examinations identified a tumor in the right middle lobe. Transbronchial lung biopsy revealed the infiltration of CD20+/CD79a+ lymphocytes invading the structure of the alveolus. MALT lymphoma was suspected, and the middle lobe was resected. The tumor was primarily invasive mucinous carcinoma, and lymphocytic infiltration was observed around the tumor. The monoclonal expansion of B cells and genetic and chromosomal abnormalities which are criteria for the diagnosis of MALT lymphoma were not demonstrated and the lesion was diagnosed as reactive lymphoid infiltrates. Marked lymphocytic infiltration regardless of neoplastic or reactive may suggest the presence of latent lesions.
肺黏膜相关淋巴组织（MALT）淋巴瘤与既往感染或自身免疫性疾病有关。我们报告一例最初疑似为MALT淋巴瘤的肺癌病例。患者为一名73岁女性。全面的筛查检查发现右中叶有一个肿瘤。经支气管肺活检显示CD20+/CD79a+淋巴细胞浸润，侵犯肺泡结构。怀疑为MALT淋巴瘤，遂切除中叶。肿瘤为原发性浸润性黏液癌，肿瘤周围可见淋巴细胞浸润。未发现B细胞的单克隆扩增以及作为MALT淋巴瘤诊断标准的基因和染色体异常，该病变被诊断为反应性淋巴浸润。无论肿瘤性或反应性，明显的淋巴细胞浸润可能提示存在潜在病变。
