Ranchod M, Lewin K J, Dorfman R F
Am J Surg Pathol. 1978 Dec;2(4):383-400. doi: 10.1097/00000478-197812000-00005.
Based on a study of 26 cases and a review of the literature, lymphoid hyperplasia of the gastrointestinal tract can be categorized into four clinicopathologic groups: focal lymphoid hyperplasia of the stomach, focal lymphoid hyperplasia of the small intestine, focal lymphoid hyperplasia of the rectum, and nodular lymphoid hyperplasia of the gastrointestinal tract. The focal lesions are single, variably circumscribed, and produce thickening of the wall of the affected part of the viscus. While a substantial number of the gastric lesions are associated with chronic peptic ulcers, ulceration is absent or insignificant in focal lesions located in the intestine. The extent of the infiltrate may range from involvement of the mucosa and submucosa only to infiltration of the full thickness of the wall. Nodular lymphoid hyperplasia of the gastrointestinal tract produces multiple discrete mucosal nodules in a variable segment of the small intestine, large intestine, or both. Gastric involvement is rare. The lymphoid infiltrate is confined to the lamina propria and superficial submucosa. Nodular lymphoid hyperplasia is most commonly encountered incidentally during radiologic examination or at autopsy, but it also occurs in association with hypogammaglobulinemia, especially late-onset acquired hypogammaglobulinemia. Lymphoid hyperplasia of the gastrointestinal tract can be distinguished from malignant lymphoma by the polymorphic nature of the infiltrate, the absence of significant cytologic atypia, and the presence of reactive follicles within the lesion.
基于对26例病例的研究及文献回顾，胃肠道淋巴样增生可分为四个临床病理组：胃局限性淋巴样增生、小肠局限性淋巴样增生、直肠局限性淋巴样增生及胃肠道结节性淋巴样增生。局限性病变为单个，边界各异，可导致受累脏器壁增厚。虽然相当数量的胃部病变与慢性消化性溃疡有关，但位于肠道的局限性病变无溃疡或仅有轻微溃疡。浸润范围可从仅累及黏膜和黏膜下层到累及肠壁全层。胃肠道结节性淋巴样增生在小肠、大肠或两者的不同节段产生多个离散的黏膜结节。胃部受累罕见。淋巴样浸润局限于固有层和浅黏膜下层。结节性淋巴样增生最常见于放射学检查或尸检时偶然发现，但也可与低丙种球蛋白血症相关，尤其是迟发性获得性低丙种球蛋白血症。胃肠道淋巴样增生可通过浸润的多形性、无明显细胞异型性以及病变内存在反应性滤泡与恶性淋巴瘤相鉴别。
