原发性干燥综合征患者小唾液腺活检诊断出的非霍奇金淋巴瘤的特征
Features of non-Hodgkin's lymphoma diagnosed in minor salivary gland biopsies from primary Sjögren's syndrome patients.
作者信息
Parreau Simon, Nocturne Gaétane, Mariette Xavier, Burroni Barbara, Lazure Thierry, Besson Florent L, Régent Alexis, Mouthon Luc, Terrier Benjamin, Seror Raphaele, Le Guern Véronique
机构信息
Department of Internal Medicine, Université Paris Descartes, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (APHP), Paris.
Department of Rheumatology, Université Paris-Saclay, FHU CARE (Cancer and Autoimmunity RElationship), INSERM UMR1184, Centre for Immunology of Viral Infections and Autoimmune Diseases, APHP, Hôpital Bicêtre, Le Kremlin-Bicêtre.
出版信息
Rheumatology (Oxford). 2022 Aug 30;61(9):3818-3823. doi: 10.1093/rheumatology/keab949.
OBJECTIVE
To evaluate the contribution of minor salivary gland biopsy (mSGB) histology in diagnosing primary SS (pSS)-associated non-Hodgkin B-cell lymphoma (NHL).
METHODS
pSS patients with mSGB at NHL diagnosis were included.
RESULTS
Among the 24 patients (92.3% female, mean age 61.3 years) with an mSGB at NHL diagnosis, 13 (54.2%) had mSGB histology-revealed NHL (mSGB+); it was the only site enabling NHL diagnosis in 10/13 (76.9%) patients. Mucosa-associated lymphoid tissue (MALT) lymphoma was found in 23/24 (95.8%) patients; 100% of mSGB+ identified MALT lymphomas. pSS and lymphoma characteristics were comparable for mSGB+ and mSGB- patients. Eight (61.5%) of the 13 mSGB+ patients and all 11 mSGB- patients were treated for lymphoma. Between diagnosis and 1 year of follow-up, the ESSDAI without the NHL item remained stable (7.4 vs 5.0; P = 0.33) for the five untreated patients, while it decreased significantly for the 19 treated patients (15.8 vs 5.1; P = 0.004).
CONCLUSION
For pSS patients with suspected NHL, mSGB histology enabled NHL diagnosis in half of them, MALT was found in 95.8% and all mSGB+ were MALT lymphomas, thereby avoiding more invasive biopsy. Our results suggest that mSGB should be obtained at pSS diagnosis and repeated during follow-up when NHL is suspected.
目的
评估小唾液腺活检（mSGB）组织学检查在诊断原发性干燥综合征（pSS）相关非霍奇金B细胞淋巴瘤（NHL）中的作用。
方法
纳入在诊断NHL时进行了mSGB的pSS患者。
结果
在诊断NHL时进行了mSGB的24例患者（92.3%为女性，平均年龄61.3岁）中，13例（54.2%）mSGB组织学检查显示为NHL（mSGB+）；在13例患者中的10例（76.9%）中，它是唯一能够诊断NHL的部位。24例患者中有23例（95.8%）发现黏膜相关淋巴组织（MALT）淋巴瘤；mSGB+的患者中100%为MALT淋巴瘤。mSGB+和mSGB-患者的pSS和淋巴瘤特征具有可比性。13例mSGB+患者中有8例（61.5%）和所有11例mSGB-患者接受了淋巴瘤治疗。在诊断至随访1年期间，5例未治疗患者的不包括NHL项目的欧洲抗风湿病联盟疾病活动指数（ESSDAI）保持稳定（7.4对5.0；P = 0.33），而19例接受治疗的患者该指数显著下降（15.8对5.1；P = 0.004）。
结论
对于疑似NHL的pSS患者，mSGB组织学检查使其中半数患者得以诊断NHL，95.8%发现MALT，且所有mSGB+均为MALT淋巴瘤，从而避免了更具侵入性的活检。我们的结果表明，应在pSS诊断时进行mSGB，并在随访期间怀疑NHL时重复进行。
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