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日本人群中B细胞型原发性胃淋巴瘤的临床病理研究,特别提及黏膜相关淋巴组织(MALT)低度B细胞淋巴瘤

[A clinicopathologic study of primary gastric lymphoma of B-cell type among the Japanese with special reference to low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT)].

作者信息

Hayashi K, Motoori T, Nakamura S, Koshikawa T, Nakamura T, Kojima M, Suchi T

机构信息

Department of Pathology and Clinical Laboratories, Aichi Cancer Center Hospital.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 1993 Dec;90(12):2985-98.

PMID:8283809
Abstract

The most common primary site of low-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is the gastrointestinal tract, particularly the stomach. The relationship of MALT lymphomas, however, with the more commonly occurring large B-cell gastric lymphoma has not been directly discussed except in the report of Chan et al. (1990), which lacked clinical information regarding the behavior of these tumors. To elucidate the relationship between high-grade large-cell lymphoma and MALT lymphoma, we studied in detail the histopathological and clinicopathologic features with the survival date of 77 Japanese cases of primary gastric lymphoma (PGL) of B-cell type. Based on degree of morphologically recognizable low- or high-grade components of the tumor, PGL was divided into four types: 18 cases of pure MALT lymphoma (type I); 13 cases of MALT lymphoma with small area of high-grade lymphoma (type II); 22 cases of high-grade lymphoma with small areas of MALT lymphoma (type III); and 24 cases pure high-grade lymphoma (type IV). Corresponding to the differences in the histologic pictures of each type, there were differences in the gross appearance, pathologic stage (including depth of invasion) and prognosis. These data suggests that both MALT and high-grade lymphomas of the stomach belong to the same cell lineage and constitute a pathological spectrum and that the histological grouping of PGL is clinico-pathologically useful.

摘要

黏膜相关淋巴组织低度B细胞淋巴瘤(MALT淋巴瘤)最常见的原发部位是胃肠道,尤其是胃。然而,除了Chan等人(1990年)的报告外,尚未直接讨论MALT淋巴瘤与更常见的大B细胞胃淋巴瘤之间的关系,该报告缺乏关于这些肿瘤行为的临床信息。为了阐明高级别大细胞淋巴瘤与MALT淋巴瘤之间的关系,我们详细研究了77例日本B细胞型原发性胃淋巴瘤(PGL)的组织病理学和临床病理特征以及生存日期。根据肿瘤形态学上可识别的低级别或高级别成分的程度,PGL分为四种类型:18例纯MALT淋巴瘤(I型);13例伴有小面积高级别淋巴瘤的MALT淋巴瘤(II型);22例伴有小面积MALT淋巴瘤的高级别淋巴瘤(III型);以及24例纯高级别淋巴瘤(IV型)。对应于每种类型组织学图像的差异,大体外观、病理分期(包括浸润深度)和预后也存在差异。这些数据表明,胃的MALT淋巴瘤和高级别淋巴瘤属于同一细胞谱系,构成一个病理谱,并且PGL的组织学分组在临床病理学上是有用的。

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