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[两例原发性肺黏膜相关淋巴组织淋巴瘤切除病例,在胸部断层扫描中的不同诊断]

[Two Resected Cases of Primary Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma, Differently Diagnosed in Chest Tomography Scan].

作者信息

Nishizawa Natsumasa, Hanagiri Takeshi, Oyama Rintaro, Ashikari Shuhei

机构信息

Department of Thoracic Surgery, Shin-Kokura Hospital.

出版信息

J UOEH. 2019;41(2):225-230. doi: 10.7888/juoeh.41.225.

Abstract

Case 1: A 81-year-old man was admitted to our hospital because of a mass shadow on chest x-ray examination. Chest computed tomography (CT) showed a 1.5 cm nodule in the middle lobe of the right lung. We suspected a primary lung cancer and performed video-assisted right middle lobectomy. Histopathological examination showed a white, elastic, hard and solid 30 × 10 × 10 mm nodule with infiltration of small-to-medium-sized lymphocytes that were positive for CD20 and CD79a, and negative for CD10 and Cyclin D1 in immunohistochemical staining. We diagnosed mucosa-associated lymphoid tissue (MALT) lymphoma. Case 2: A 67-year-old woman was admitted to our hospital because of a mass shadow in the right upper lobe on chest x-ray and chest CT. As the lesion had not grow in 1 year, the patient strongly wanted it resected, therefore we performed wedge resetion of the right upper lobe via video-assisted thoracic surgery. Histopathological examination showed a white, elastic, hard and solid 25 × 25 × 16 mm nodule with infiltration of small-to-medium-sized lymphocytes that had positive staining of CD20 and CD79a, and negative staining of CD10 and Cyclin D1. We diagnosed MALT lymphoma. Primary lung MALT lymphoma shows a variety of shadows on chest CT, similar to lung cancer and other inflammatory diseases. Local therapies such as surgery and radiation therapy are effective against early stage MALT lymphoma, but there is no consensus of a standard surgery.

摘要

病例 1:一名 81 岁男性因胸部 X 线检查发现肿块阴影入院。胸部计算机断层扫描(CT)显示右肺中叶有一个 1.5 cm 的结节。我们怀疑是原发性肺癌,遂进行了电视辅助右肺中叶切除术。组织病理学检查显示一个白色、有弹性、坚硬且实性的 30×10×10 mm 结节,有小到中等大小淋巴细胞浸润,免疫组化染色显示 CD20 和 CD79a 阳性,CD10 和 Cyclin D1 阴性。我们诊断为黏膜相关淋巴组织(MALT)淋巴瘤。病例 2:一名 67 岁女性因胸部 X 线和胸部 CT 显示右上叶有肿块阴影入院。由于病变 1 年内未生长,患者强烈要求切除,因此我们通过电视辅助胸腔镜手术对右上叶进行了楔形切除术。组织病理学检查显示一个白色、有弹性、坚硬且实性的 25×25×16 mm 结节,有小到中等大小淋巴细胞浸润,CD20 和 CD79a 染色阳性,CD10 和 Cyclin D1 染色阴性。我们诊断为 MALT 淋巴瘤。原发性肺 MALT 淋巴瘤在胸部 CT 上表现出多种阴影,类似于肺癌和其他炎症性疾病。手术和放疗等局部治疗对早期 MALT 淋巴瘤有效,但对于标准手术尚无共识。

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