Diss T C, Wotherspoon A C, Speight P, Pan L, Isaacson P G
Department of Histopathology, University College London Medical School, U.K.
Am J Surg Pathol. 1995 May;19(5):531-6. doi: 10.1097/00000478-199505000-00004.
Low-grade mucosa-associated lymphoid tissue (MALT) type B-cell lymphomas of the salivary gland arise in a background of myoepithelial sialadenitis (MESA), usually in association with Sjögren's syndrome. The distinction between benign MESA and early lymphoma has proved difficult using histological criteria alone and the significance of B-cell monoclonality in this respect is controversial. We have used immunohistochemistry and polymerase chain reaction (PCR) amplification of immunoglobulin heavy-chain VDJ regions to assess clonality in biopsies from 45 patients with lymphoid infiltration of the parotid. Sequential biopsies spanning 3-18 years were available from seven patients, three of whom had developed disseminated nodal B-cell lymphoma. In light of previous studies, each biopsy was additionally analyzed for the presence of t(14;18) and Epstein Barr Virus (EBV) DNA using PCR. Monoclonality was detected in 34/45 cases. Comparison of histology with clonality confirmed earlier suggestions that the emergence of an identifiable population of centrocyte-like B cells around ducts or epithelial islands correlated with monoclonality. In six of seven patients with sequential biopsies PCR fragments of identical size were amplified from each biopsy, suggesting that demonstrable monoclonality in "lymphoepithelial" lymphoproliferative lesions of the salivary gland is indicative of lymphoma. No t(14;18) chromosome translocations were identified; EBV sequences were detected in three of 45 cases.
涎腺低度黏膜相关淋巴组织（MALT）型B细胞淋巴瘤发生于肌上皮涎腺炎（MESA）背景下，通常与干燥综合征相关。仅使用组织学标准很难区分良性MESA和早期淋巴瘤，B细胞单克隆性在这方面的意义也存在争议。我们采用免疫组织化学和免疫球蛋白重链VDJ区的聚合酶链反应（PCR）扩增，评估45例腮腺淋巴样浸润患者活检标本中的克隆性。7例患者有跨度为3至18年的系列活检标本，其中3例已发展为弥漫性淋巴结B细胞淋巴瘤。根据先前的研究，使用PCR对每个活检标本额外分析t(14;18)和爱泼斯坦-巴尔病毒（EBV）DNA的存在情况。45例中有34例检测到单克隆性。组织学与克隆性的比较证实了早期的观点，即导管或上皮岛周围出现可识别的中心细胞样B细胞群与单克隆性相关。在7例有系列活检标本的患者中，6例每次活检均扩增出大小相同的PCR片段，提示涎腺“淋巴上皮”性淋巴增殖性病变中可证实的单克隆性表明为淋巴瘤。未发现t(14;18)染色体易位；45例中有3例检测到EBV序列。
