Miura Hiroyuki, Miura Jun, Goto Shinichi, Yamamoto Tomoko
Department of Thoracic Surgery Akiru Municipal Medical Centre Tokyo Japan.
Department of Surgery Kyorin University School of Medicine Tokyo Japan.
Respirol Case Rep. 2024 May 1;12(5):e01364. doi: 10.1002/rcr2.1364. eCollection 2024 May.
Mucosa-associated lymphoid tissue (MALT) is a low-grade lymphoma, but cases in which it has transformed into a high-grade lymphoma have been reported, necessitating an accurate diagnosis. The patient was a 79-year-old nonsmoking Japanese female with history of ocular sarcoidosis. A computed tomography scan of her chest revealed a 35-mm nodule in the left S1 + 2, contiguous with the lymph nodes. Additional nodules were observed around the left B5 and B10a. Bronchoscopy revealed stenosis caused by a white, glossy, elevated lesion with angiogenesis at the orifice of the left upper lobe bronchus. The biopsy specimen demonstrated the dominance of lymphoid cells and tested positive for CD20, CD79a, Bcl-2, and IRTA-1, which is consistent with the findings in MALT lymphoma. Therefore, in the presence of multiple infiltrative shadows along the bronchi with glossy elevated lesions without necrosis on bronchoscopy, it is important to consider MALT lymphoma as a differential diagnosis.
黏膜相关淋巴组织(MALT)淋巴瘤是一种低度恶性淋巴瘤,但已有转化为高度恶性淋巴瘤的病例报道,因此需要准确诊断。该患者为一名79岁不吸烟的日本女性,有眼部结节病病史。胸部计算机断层扫描显示左肺上叶S1+2区有一个35毫米的结节,与淋巴结相连。在左肺B5和B10a周围还观察到其他结节。支气管镜检查显示左上叶支气管开口处有一个白色、光滑、隆起的病变,伴有血管生成,导致管腔狭窄。活检标本显示以淋巴细胞为主,CD20、CD79a、Bcl-2和IRTA-1检测呈阳性,这与MALT淋巴瘤的表现一致。因此,当支气管镜检查发现沿支气管有多个浸润性阴影,伴有光滑隆起的病变且无坏死时,将MALT淋巴瘤作为鉴别诊断很重要。