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放射治疗气管黏膜相关淋巴组织淋巴瘤:一例报告

Mucosa-associated lymphoid tissue lymphoma of the trachea treated with radiotherapy: A case report.

作者信息

Zhen Chan-Jun, Zhang Ping, Bai Wen-Wen, Song Yu-Zhi, Liang Jun-Li, Qiao Xue-Ying, Zhou Zhi-Guo

机构信息

Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.

Nursing Department, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.

出版信息

World J Clin Cases. 2023 Mar 6;11(7):1607-1614. doi: 10.12998/wjcc.v11.i7.1607.

Abstract

BACKGROUND

Mucosa-associated lymphoid tissue (MALT) lymphoma originates in the marginal zone of lymphoid tissue. lung is one of the most frequent non-gastrointestinal organs involved, here known as bronchus-associated lymphoid tissue (BALT) lymphoma. BALT lymphoma of unknown etiology, and most patients are asymptomatic. The treatment of BALT lymphoma is controversial.

CASE SUMMARY

A 55-year-old man admitted to hospital had a three-month history of progressively coughing up yellow sputum, chest stuffiness, and shortness of breath. Fiberoptic bronchoscopy revealed mucosal visible beaded bumps 4 cm from the tracheal carina at 9 o 'clock and 3 o 'clock, the right main bronchus, and the right upper lobe bronchus. Biopsy specimens showed MALT lymphoma. Computed tomography virtual bronchoscopy (CTVB) showed uneven main bronchial wall thickening and multiple nodular protrusion. BALT lymphoma stage IE was diagnosed after a staging examination. We treated the patient with radiotherapy (RT) alone. A total dose of 30.6 Gy/17 f/25 d was given. The patient had no obvious adverse reactions during RT. The CTVB was repeated after RT and showed that the right side of the trachea was slightly thickened. CTVB was repeated 1.5 mo after RT and again showed that the right side of the trachea was slightly thickened. Annual CTVB showed no signs of recurrence. The patient now has no symptoms.

CONCLUSION

BALT lymphoma is an uncommon disease and shows good prognosis. The treatment of BALT lymphoma is controversial. In recent years, less invasive diagnostic and therapeutic approaches have been emerging. RT was effective and safe in our case. The use of CTVB could provide a noninvasive, repeatable, and accurate method in diagnosis and follow-up.

摘要

背景

黏膜相关淋巴组织(MALT)淋巴瘤起源于淋巴组织的边缘区。肺是最常受累的非胃肠道器官之一,在此称为支气管相关淋巴组织(BALT)淋巴瘤。BALT淋巴瘤病因不明,大多数患者无症状。BALT淋巴瘤的治疗存在争议。

病例摘要

一名55岁男性入院,有3个月逐渐咳出黄色痰液、胸闷和气短的病史。纤维支气管镜检查显示,在右主支气管和右上叶支气管距气管隆突9点和3点方向4 cm处可见黏膜呈串珠样隆起。活检标本显示为MALT淋巴瘤。计算机断层扫描虚拟支气管镜(CTVB)显示主支气管壁增厚不均匀,有多个结节状突出。经分期检查后诊断为BALT淋巴瘤IE期。我们仅对患者进行了放射治疗(RT)。给予的总剂量为30.6 Gy/17次/25天。患者在放疗期间无明显不良反应。放疗后复查CTVB显示气管右侧稍增厚。放疗后1.5个月复查CTVB,再次显示气管右侧稍增厚。每年复查CTVB均无复发迹象。患者目前无症状。

结论

BALT淋巴瘤是一种罕见疾病,预后良好。BALT淋巴瘤的治疗存在争议。近年来,微创诊断和治疗方法不断涌现。在我们的病例中,放疗有效且安全。CTVB的应用可为诊断和随访提供一种无创、可重复且准确的方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf24/10011992/c750a8633ba2/WJCC-11-1607-g001.jpg

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