原发性肺黏膜相关淋巴组织淋巴瘤伴淀粉样轻链型淀粉样变性

Primary pulmonary mucosa-associated lymphoid tissue lymphoma with amyloid light chain-type amyloidosis.

作者信息

Ohara Shuta, Tomizawa Kenji, Shimizu Shigeki, Suda Kenichi, Fujino Toshio, Hamada Akira, Koga Takamasa, Nishino Masaya, Kobayashi Yoshihisa, Sato Katsuaki, Chiba Masato, Shimoji Masaki, Takemoto Toshiki, Soh Junichi, Mitsudomi Tetsuya

机构信息

Division of Thoracic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan.

Department of Pathology, Faculty of Medicine, Kindai University, Ohno-Higashi, Osaka-Sayama, Japan.

出版信息

Surg Case Rep. 2019 Jun 26;5(1):105. doi: 10.1186/s40792-019-0663-0.

DOI:10.1186/s40792-019-0663-0

PMID:31243589

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6595020/

Abstract

BACKGROUND

A total of 75% of patients with Sjögren's syndrome are complicated with pulmonary lesions, of which 12% are lymphoma and 6% are amyloid nodules; the coexistence of both is considered to be rare.

CASE PRESENTATION

A 67-year-old female with Sjögren's syndrome presented with multiple pulmonary nodules on chest computed tomography. Since a definitive diagnosis by transbronchial biopsy was not obtained, wedge resection of the nodules was performed. Pathologic diagnosis revealed eosinophilic deposition that stained positive with Congo red. In addition, lymphoepithelial lesions and lymphocytic infiltration were observed. Lymphocytes with monoclonal proliferation predominantly had κ chain. Based on these findings, the nodules were diagnosed as mucosa-associated lymphoid tissue (MALT) lymphoma with amyloid deposition.

CONCLUSIONS

The combination of these diseases is very rare, and this is the sixth resected case to the best of our knowledge.

摘要

背景

干燥综合征患者中共有75%合并肺部病变，其中12%为淋巴瘤，6%为淀粉样结节；两者并存被认为较为罕见。

病例介绍

一名67岁干燥综合征女性患者胸部计算机断层扫描显示多发肺结节。由于经支气管活检未获得明确诊断，遂对结节进行楔形切除术。病理诊断显示刚果红染色阳性的嗜酸性沉积。此外，观察到淋巴上皮病变和淋巴细胞浸润。单克隆增殖的淋巴细胞主要具有κ链。基于这些发现，结节被诊断为伴有淀粉样沉积的黏膜相关淋巴组织（MALT）淋巴瘤。