Primary Pulmonary Mucosa-associated Lymphoid Tissue Lymphoma with Amyloidosis and Lymphoid Interstitial Pneumonitis-A Case Report

原發性肺部黏膜相關類淋巴組織之淋巴瘤合併類澱粉沉積及淋巴球間質肺炎－病例報告

翁銘偉(Ming-Wei Weng) ； 王鴻昌(Hong-Chung Wang) ； 張慶宏(Chin-Hung Chang) ； 林秀玲(Shong-Ling Lin) ； 賴瑞生(Ruay-Sheng Lai)

《胸腔醫學》 24卷4期 (2009/08) Pp. 206-211

https://doi.org/10.29806/TM.200908.0004

摘要

原發性黏膜相關類淋巴組織之淋巴瘤(MALToma)在肺部是相當罕見的，尤其是合併有淋巴球間質肺炎。在此我們報告一位66歲男性病患因嚴重咳血三天而住院。胸部電腦斷層呈現左下肺部有一8×8×6公分腫瘤病灶及雙側肺野廣泛囊狀浸潤。左下肺葉切除術後病理報告顯示有廣泛淋巴細胞及漿細胞增生且CD20染色呈陽性反應。另外剛果紅染色也發現類澱粉沉積。淋巴上皮細胞已滲透至左下肺實質的囊狀部位。以上病理變化苻合黏膜相關類淋巴組織之淋巴瘤合併類澱粉沉積及淋巴球間質肺炎的診斷。因淋巴球間質肺炎可能為黏膜相關類淋巴組織之淋巴瘤的一個表癥，所以廣泛性囊狀病灶的病人需考慮原發性肺部黏膜相關類淋巴組織之淋巴瘤的可能。

關鍵字

類澱粉沉積 ； 淋巴球間質肺炎 ； 黏膜相關類淋巴組織之淋巴瘤

並列摘要

Pulmonary mucosa-associated lymphoid tissue lymphoma (MALToma) is rare, especially when combined with lymphoid interstitial pneumonitis (LIP). We report the case of a 66-year-old man who was admitted because of severe hemoptysis for 3 days. Computed tomography (CT) scan of the chest showed a mass-like lesion (8×8×6 cm^3) in the left lower lobe and diffuse cystic lesions in both lungs. Pathologic study of the specimens after left lower lobectomy revealed diffuse infiltration of lymphoid cells and plasma cells positive for CD20. Congo red stain also showed amyloid deposition. Lymphoepithelial cells had infiltrated throughout the cystic area of the pulmonary parenchyma in the left lower lobe. These findings were compatible with the diagnosis of MALToma, with amyloidosis and LIP. Since LIP may be a presentation of MALToma, primary pulmonary MALToma should be considered for cases of nodular or mass lesion combined with diffuse cystic lung disease.

並列關鍵字

MALToma ； amyloidosis ； lymphocytic interstitial pneumonia