Hyjek E, Smith W J, Isaacson P G
Department of Histopathology, University College, and Middlesex Hospital Medical School, London, England.
Hum Pathol. 1988 Jul;19(7):766-76. doi: 10.1016/s0046-8177(88)80259-4.
A detailed morphologic and immunohistochemical study has been carried out on salivary glands excised from 20 cases in which the initial histologic diagnosis was either myoepithelial sialadenitis (MESA) or salivary gland lymphoma (SGL). The results have shown that these cases, except one that had been diagnosed as MESA, showed a spectrum of changes ranging from focal lymphoid infiltrates, designated as early MESA, through established MESA with dense, extensive lymphoid infiltration, to lymphoma. The distribution of the lymphoid infiltrate in early MESA was related to ducts and mimicked Peyers patches. In established MESA, this infiltrate became confluent with the formation of prominent epimyoepithelial islands. The evolution of lymphoma was characterized by an expanded population of centrocyte-like (CCL) cells that showed light chain restriction. Like other lymphomas of mucosa-associated lymphoid tissue, to which they bear a striking resemblance, salivary gland lymphomas may remain localized for prolonged periods with a tendency to local recurrence rather than to distant spread. These properties may be explained by the histogenesis of these tumors from CCL cells that appear to be of similar lineage of splenic marginal zone cells.
对20例最初组织学诊断为肌上皮涎腺炎（MESA）或涎腺淋巴瘤（SGL）的患者切除的涎腺进行了详细的形态学和免疫组织化学研究。结果显示，除1例诊断为MESA的病例外，这些病例呈现出一系列变化，从局灶性淋巴细胞浸润（称为早期MESA），到具有密集、广泛淋巴细胞浸润的典型MESA，再到淋巴瘤。早期MESA中淋巴细胞浸润的分布与导管相关，并模仿派伊尔结。在典型MESA中，这种浸润融合形成突出的上皮肌上皮岛。淋巴瘤的演变特征是中心细胞样（CCL）细胞群体扩大，显示轻链限制。涎腺淋巴瘤与其他黏膜相关淋巴组织淋巴瘤极为相似，可能长期局限，有局部复发倾向而非远处转移。这些特性可能由这些肿瘤起源于CCL细胞来解释，CCL细胞似乎与脾边缘区细胞有相似的谱系。
