Isaacson P G, Banks P M, Best P V, McLure S P, Muller-Hermelink H K, Wyatt J I
Department of Histopathology, UCL Medical School, London, England.
Am J Surg Pathol. 1995 May;19(5):571-5. doi: 10.1097/00000478-199505000-00009.
We describe the clinical, histological, and immunohistochemical features of four cases of primary low-grade B-cell lymphoma of the liver. The lymphomas were first seen as a solitary nodule in two patients and as two nodules in the third patient. These were found incidentally in an otherwise normal liver during abdominal surgery for other causes. In the fourth patient, several up to 2 cm nodules of lymphoma were found in a liver removed before transplant for chronic active hepatitis and cirrhosis. There was no evidence of lymphoma elsewhere in any of the patients. One patient has remained well, without evidence of lymphoma, 1 year after resection, one died intraoperatively, one is lost to follow-up, and the transplanted patient died 1 year after transplant from complications without evidence of recurrent lymphoma. The histology was typical of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT)-type with centrocyte-like cells surrounding reactive B-cell follicles and forming lymphoepithelial lesions with bile ducts. Primary hepatic lymphomas are rare, and most reported cases have been high-grade B-cell lesions. The liver should be added to the list of extranodal sites where low-grade MALT lymphoma may occur.
我们描述了4例原发性肝脏低级别B细胞淋巴瘤的临床、组织学及免疫组化特征。其中2例患者的淋巴瘤最初表现为单个结节，第3例患者表现为2个结节。这些结节是在因其他原因进行腹部手术时，于原本正常的肝脏中偶然发现的。在第4例患者中，因慢性活动性肝炎和肝硬化接受移植前切除的肝脏中发现了几个直径达2厘米的淋巴瘤结节。所有患者的其他部位均未发现淋巴瘤证据。1例患者切除术后1年情况良好，无淋巴瘤迹象；1例患者术中死亡；1例失访；移植患者在移植后1年因并发症死亡，无复发性淋巴瘤证据。组织学表现为典型的黏膜相关淋巴组织（MALT）型低级别B细胞淋巴瘤，中心细胞样细胞围绕反应性B细胞滤泡，并与胆管形成淋巴上皮病变。原发性肝脏淋巴瘤较为罕见，大多数报道的病例为高级别B细胞病变。肝脏应被列入可能发生低级别MALT淋巴瘤的结外部位清单。
