Satoh T, Yamada T, Nakano S, Tokunaga O, Kuramochi S, Kanai T, Ishikawa H, Ogihara T
Department of Pathology, Saga Medical School, Japan.
Cancer. 1997 Nov 15;80(10):1981-8. doi: 10.1002/(sici)1097-0142(19971115)80:10<1981::aid-cncr16>3.0.co;2-u.
An etiologically important role has been suggested for hepatitis C virus (HCV) infection in the development of B-cell non-Hodgkin's lymphoma (NHL). HCV has been recognized as the major cause of non-A, non-B chronic hepatitis throughout the world. Moreover, the occurrence of primary splenic malignant lymphoma (PSML) has been demonstrated in patients with chronic liver disease.
In this study, the authors describe three patients with PSML. The clinical, histologic, and immunohistochemical features of the lymphomas were studied. Clonal immunoglobulin heavy chain gene rearrangement was investigated by polymerase chain reaction.
All three cases of PSML were detected by imaging studies performed in routine follow-up of cases of chronic liver disease associated with HCV infection. Macronodular lesions were found in the three spleens; two of them were of normal weight and another was moderately enlarged. The former two were the smallest PSMLs reported to date. The histology was B-cell NHL in all cases. All 3 patients were alive after splenectomy with an average follow-up of 51.7 months (range, 35-74 months).
HCV infection may play an etiologic role in the development of splenic B-cell lymphoma. The long survival of the patients in this study may have been due to early splenectomy.
丙型肝炎病毒（HCV）感染在B细胞非霍奇金淋巴瘤（NHL）的发生发展中被认为具有重要的病因学作用。HCV已被公认为全世界非甲非乙型慢性肝炎的主要病因。此外，慢性肝病患者中已证实存在原发性脾恶性淋巴瘤（PSML）。
在本研究中，作者描述了3例PSML患者。对淋巴瘤的临床、组织学和免疫组化特征进行了研究。通过聚合酶链反应研究克隆性免疫球蛋白重链基因重排。
所有3例PSML均在对HCV感染相关慢性肝病病例进行常规随访的影像学检查中被发现。在3个脾脏中发现了大结节性病变；其中2个脾脏重量正常，另一个中度肿大。前两个是迄今为止报道的最小的PSML。所有病例的组织学类型均为B细胞NHL。所有3例患者脾切除术后均存活，平均随访51.7个月（范围35 - 74个月）。
HCV感染可能在脾B细胞淋巴瘤的发生中起病因学作用。本研究中患者的长期存活可能归因于早期脾切除术。
