Burke J S
Department of Anatomic Pathology, Alta Bates Medical Center, Berkeley, California 94705, USA.
Am J Clin Pathol. 1999 Jan;111(1 Suppl 1):S133-43.
To qualify as a low-grade lymphoma of mucosa-associated lymphoid tissue (MALT) type, lymphomas at different extranodal sites must conform to specific morphologic features. Lymphoepithelial lesions are typical, and follicular colonization is common. Regardless of site, many MALT lymphomas are associated with a predisposing condition, infectious or autoimmune, leading to the acquisition of extranodal MALT. MALT lymphomas in different regions usually have limited disease and indolent clinical courses in which survival does not substantially differ from healthy controls. There is a tendency for diverse cytologic expressions among different MALT lymphomas, such as small lymphocytes in the lung, monocytoid cells in salivary glands, and plamacytic cells in the thyroid and skin, but the site-specific morphologic differences mainly reflect the unique topographic characteristics of the involved organ, and these topographic features also influence the clinical traits. Some of the unparalleled features of MALT lymphomas in different sites include the association of gastric MALT lymphomas with Helicobacter pylori, the lymphangitic distribution of pulmonary MALT cases, and the relationship between MALT lymphomas of the salivary gland and thyroid with Sjögren's syndrome and Hashimoto's thyroiditis, respectively. The ocular cases and those of the skin, breast, and dura also have characteristic clinical modes of presentation largely owing to the anatomic locale of the lymphoma.
要符合黏膜相关淋巴组织(MALT)型低级别淋巴瘤的标准,不同结外部位的淋巴瘤必须符合特定的形态学特征。淋巴上皮病变很典型,滤泡浸润也很常见。无论部位如何,许多MALT淋巴瘤都与一种易感状况相关,这种状况可以是感染性的或自身免疫性的,会导致结外MALT的形成。不同区域的MALT淋巴瘤通常疾病局限,临床病程进展缓慢,其生存率与健康对照相比无显著差异。不同的MALT淋巴瘤存在多种细胞形态学表现的倾向,比如肺内为小淋巴细胞,唾液腺内为单核样细胞,甲状腺和皮肤内为浆细胞,但部位特异性形态学差异主要反映了受累器官独特的局部解剖特征,而这些局部解剖特征也会影响临床特点。不同部位MALT淋巴瘤一些独特的特征包括胃MALT淋巴瘤与幽门螺杆菌的关联、肺MALT病例的淋巴管周围分布,以及唾液腺和甲状腺的MALT淋巴瘤分别与干燥综合征和桥本甲状腺炎的关系。眼部以及皮肤、乳腺和硬脑膜部位的病例也有各自独特的临床呈现方式,这很大程度上归因于淋巴瘤所在的解剖位置。