【呼吸系统】黏膜相关淋巴组织淋巴瘤 | MALT lymphoma

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【MALT lymphoma】

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1

病史

64/F, Incidental radiologic abnormality.

64岁女性，偶发影像异常表现。

2

影像学检查

图1 胸片正位

图2 胸部CT肺窗

图3 胸部CT肺窗

图4 胸部CT增强纵隔窗

图5 3年前胸部CT肺窗

图6 9年前胸部CT肺窗

3

影像学表现

Fig 1. Chest PA shows focal increased opacity in the right upper lung field.

图1胸片显示右肺上野局灶性高密度影。

Fig 2-6. Chest CT images demonstrate an ill-defined mass-like consolidation with air-bronchogram in the right upper lobe. Enhanced CT shows a relatively homogeneously enhancing consolidation.

图2-6.胸部CT显示右肺上叶肿块样实变，边界不清，半支气管充气征。增强CT显示实变相对均匀强化。

Former CT reveals that the size of the consolidation has slowly increased over the span of nine years.

老片显示9年内实变大小缓慢增长。

Percutaneous needle biopsy revealed Mucosa associated lymphoid tissue (MALT) lymphoma.

经皮穿刺活检显示黏膜相关淋巴组织淋巴瘤。

4

诊断

MALT lymphoma

黏膜相关淋巴组织淋巴瘤

5

诊断要点

MALT lymphoma is a monoclonal lymphoid proliferation arising from a B-cell progenitor within bronchial associated lymphoid tissue (BALT), and is classified as low-grade marginal zone B-cell lymphoma.

MLAT淋巴瘤是一种支气管相关淋巴组织（BALT）内B细胞的祖细胞引起的单克隆淋巴增生，为低度边缘区B细胞淋巴瘤。

Radiography shows nodules, masses, and/or consolidation.

胸片显示结节、肿块和/或实变。

CT shows multiple nodules, masses, and/or nodular/mass-like areas of ground-glass attenuation or consolidation, which tend to be in a bronchovascular distribution and often show air bronchogram.

CT显示多发结节、肿块和/或结节/肿块样磨玻璃影或实变，趋向于支气管血管束分布，常伴支气管充气征。

Halo of ground-glass shadowing or peribronchovascular thickening at tumor margins, and discrete patches of ground glass shadowing, positive angiogram sign on contrast enhanced CT can also be seen.

CT还可见病灶边缘磨玻璃密度晕或支气管血管束增粗，片状磨玻璃影。增强CT显示血管造影征阳性。

Slowly progressive pulmonary consolidation in conjunction with a supportive history of autoimmune disease or lymphoma in another mucosal site should strongly suggest the diagnosis of MALT lymphoma.

缓慢浸润性肺实变结合自身免疫性疾病其他粘膜部位淋巴瘤或的病史应强烈提示MLAT淋巴瘤。

MALT lymphoma lesions are hypermetabolic at PET/CT approximately half of the time.

约一半MLAT淋巴瘤病灶在PET/CT表现为高摄取。

Treatment is usually with chemotherapy or immunotherapy (rituximab). Surgery and radiation therapy are options available for localized disease.

治疗通常是化疗或免疫治疗（利妥昔单抗）。外科手术和放疗可用于局部病灶。

The prognosis is good, with 5- and 10-year survival rates ranging from 84% to 88%.

预后良好，5年和10年生存率在84%到88%之间。

参考文献：

1.Kum Ju Chae, Gong Yong Jin / Chonbuk National University College of Medicine.kstr.radiology.

词汇学习

lymphoma[lɪmˈfəʊmə] ：n.淋巴瘤

right upper lung field：右上肺野

consolidation：实变

monoclonal [ˌmɒnəʊ'kləʊnəl]：adj.单克隆的

low-grade：低度