Hirakawa K, Fuchigami T, Nakamura S, Daimaru Y, Ohshima K, Sakai Y, Ichimaru T
Division of Gastroenterology, Matsuyama Red Cross Hospital, Japan.
Gastroenterology. 1996 Sep;111(3):778-82. doi: 10.1053/gast.1996.v111.pm8780585.
An extremely rare case of primary gastrointestinal T-cell lymphoma involving the stomach and intestine is reported. Radiographic and endoscopic examinations showed multiple polypoid lesions covered by a normal-appearing mucosa in the stomach, duodenal bulb, and terminal ileum and numerous small aphthoid lesions throughout the entire colorectum. Histopathologic, immunohistochemical, and polymerase chain reaction studies were performed using paraffin-embedded or fresh-frozen specimens from endoscopic biopsies and endoscopic mucosal resections. All lesions were composed of small, atypical lymphoid cells, which were classified as low-grade pleomorphic lymphoma. The tumor cells expressed CD3, CD4, and the T-cell receptor gamma gene phenotype as well as human mucosal lymphocyte 1 antigen, suggesting that the lymphoma cells were derived from intraepithelial T lymphocytes. This is the first description of primary gastrointestinal T-cell lymphoma with expression of human mucosal lymphocyte 1 antigen and a novel morphology resembling multiple lymphomatous polyposis.
报道了一例极其罕见的原发性胃肠道T细胞淋巴瘤，累及胃和肠道。影像学和内镜检查显示，在胃、十二指肠球部和回肠末端有多个被外观正常的黏膜覆盖的息肉样病变，在整个结直肠有许多小的口疮样病变。使用来自内镜活检和内镜黏膜切除术的石蜡包埋或新鲜冷冻标本进行了组织病理学、免疫组织化学和聚合酶链反应研究。所有病变均由小的非典型淋巴细胞组成，被分类为低级别多形性淋巴瘤。肿瘤细胞表达CD3、CD4、T细胞受体γ基因表型以及人黏膜淋巴细胞1抗原，提示淋巴瘤细胞来源于上皮内T淋巴细胞。这是对具有人黏膜淋巴细胞1抗原表达及类似多灶性淋巴瘤样息肉病新形态的原发性胃肠道T细胞淋巴瘤的首次描述。
