Harris S, Wilkins B S, Jones D B
University Pathology, Southampton General Hospital, U.K.
J Pathol. 1996 May;179(1):49-53. doi: 10.1002/(SICI)1096-9896(199605)179:1<49::AID-PATH522>3.0.CO;2-G.
It has been suggested that lymphocytes of mucosa-associated lymphoid tissue (MALT) arise from marginal zone cells and that MALT-derived lymphomas may spread to other extra-nodal sites by homing to marginal zones in different tissues. Marginal zone expansion has been observed in spleens removed during surgery for gastrointestinal MALT lymphoma, which was sufficiently extreme in some cases to suggest neoplastic involvement. To investigate this phenomenon, polymerase chain reaction (PCR) amplification of immunoglobulin heavy chain gene fragments was performed to demonstrate B-cell clonality in gastrointestinal MALT lymphomas and spleens from 11 patients. Monoclonal PCR products were obtained from 9 of the 11 gastrointestinal tumours but from none of the accompanying spleens. One additional spleen, for which the accompanying gastric lymphoma tissue was unavailable for review, yielded a monoclonal product. However, obvious lymphoma deposits were present in this specimen, in addition to marginal zone enlargement. It is concluded that splenic marginal zone expansion accompanying gastrointestinal MALT lymphoma is correctly interpreted as being reactive. Splenic involvement by MALT lymphoma is uncommon and does not show preferential colonization of the marginal zone to suggest homing of MALT-derived cells to this site.
有人提出，黏膜相关淋巴组织（MALT）的淋巴细胞起源于边缘区细胞，且源自MALT的淋巴瘤可能通过归巢至不同组织的边缘区而扩散至其他结外部位。在因胃肠道MALT淋巴瘤行手术切除的脾脏中观察到边缘区扩张，在某些病例中这种扩张非常明显，提示存在肿瘤累及。为研究这一现象，对11例患者的胃肠道MALT淋巴瘤及脾脏进行免疫球蛋白重链基因片段的聚合酶链反应（PCR）扩增，以证明B细胞克隆性。11例胃肠道肿瘤中有9例获得单克隆PCR产物，但所有伴发的脾脏均未获得。另外1例脾脏，因伴发的胃淋巴瘤组织无法用于检查，获得了单克隆产物。然而，除边缘区增大外，该标本中还存在明显的淋巴瘤沉积物。结论是，胃肠道MALT淋巴瘤伴发的脾脏边缘区扩张正确解释应为反应性改变。MALT淋巴瘤累及脾脏并不常见，且未显示边缘区有优先定植现象，提示源自MALT的细胞不会归巢至该部位。
