- 期刊
Primary Hepatic Mucosa-associated Lymphoid Tissue Lymphoma Mimicking Cholangiocarcinoma: Report of a Case
類似膽管癌的原發性肝臟黏膜相關淋巴組織淋巴瘤：一病例報告
摘要
原發性肝臟黏膜相關淋巴組織淋巴瘤是種罕見的疾病。本次個案是位80歲男性，最初表現為巨大肝左葉腫瘤。超音波下此肝臟腫瘤呈現十公分左右的低回音顯影。實驗室分析和影像報告皆診斷其為膽管癌，然而超音波導引取樣的切片病理報告為慢性發炎的肉芽組織。因此，改用腹腔鏡手術摘取部份的肝臟腫瘤後，其切片病理顯示為原發性肝臟黏膜相關淋巴組織淋巴瘤。在免疫組織化學染色法下，顯示腫瘤為CD20和CD23陽性。進一步的檢查其它部份則未有淋巴瘤的證據。此腫瘤的病理機轉仍然不明，但之前研究認為其與慢性發炎性疾病相關。本文章將從臨床表現、病理學以及免疫組織化學染色的特徵與治療來討論此罕見疾病。
並列摘要
Primary hepatic marginal zone B-cell lymphoma of the mucosa associated lymphoid tissue (MALT) is an extremely rare disease. We report the case of an 80-year-old man presenting with a huge hepatic mass in the left lobe. The mass measured approximately 10 cm and appeared with mixed echogenicity on sonography. The laboratory and imaging studies suggest cholangiocarcinoma. Sono-guide fine needle biopsy revealed a picture of chronic granulomatous inflammation. We performed laparoscopic biopsy to clarify the discrepancy between clinical histology and fine needle biopsy. The histology of laparoscopic biopsy showed dense infiltration of smallsized lymphocytes, centrocyte-like (marginal zone) and monocytoid cells with immunostaining positive for CD 20 and focally positive for CD 21 suggestive of primary hepatic MALT lymphoma. There was no evidence of lymphoma involvement at other sites. The pathogenesis of primary hepatic MALT lymphoma remains unclear; however, previous studies suggested the role of chronic inflammatory disease. Diagnosis of primary hepatic MALT lymphoma might require adequate amount of liver tissue and immunostaining.
延伸閱讀
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