Pulmonary Mucosa-Associated Lymphoid Tissue Lymphoma (P-MALToma) in a Patient with Chronic Pleural Effusion

肺黏膜相關淋巴組織淋巴瘤（MALT淋巴瘤）於慢性肋膜積水和真菌感染的病人

林縵婷(Ting-Ting Ling) ； 吳子卿(Tzu-Ching Wu) ； 吳銘芳(Ming-Fang Wu) ； 賴銘淙(Ming-Tsung Lai) ； 曹世明(Shih-Ming Tsao)

《胸腔醫學》 28卷2期 (2013/04) Pp. 89-95

摘要

黏膜相關淋巴組織淋巴瘤（MALToma）是一種低度惡性度的B細胞淋巴瘤。它可生長在胃、肺、唾液腺、甲狀腺或前列腺。肺部黏膜相關淋巴組織的淋巴瘤（p-MALToma）是個很少見疾病。雖然MALToma是惡性腫瘤，但是其臨床表現及特性是屬於進展緩慢的疾病（indolent）且預後良好。我們報告一位72歲女性罹患MALToma被診斷的時候是，以左側的大量肋膜積水來表現。一年來，病人除一開始的抗黴菌藥與長期服用clarithromycin 外並未接受任何化學治療，胸部X光至今無明顯變化。正如幽門桿菌感染已確定為胃部MALToma的致病因子，結核菌感染也被認為在p-MALToma伴演重要角色。因此，本文個案患有陳舊性結核病與慢性肋膜積水更可以讓我們思考慢性感染與MALToma之間的關係。

關鍵字

肋膜積水 ； 肺部黏膜相關淋巴組織淋巴瘤(p-MALToma) ； 克拉霉素

並列摘要

Pulmonary mucosa-associated lymphoid tissue lymphoma (P-MALToma) is a rare disease. We presented the case of a 72-year-old woman who was admitted to the hospital because of increasing dyspnea. Her chest roentgenogram revealed left upper lung consolidation complicated with left-side pleural effusion and enlarged right upper lobe consolidation, compared to a chest roentgenogram in 2007. She was diagnosed with lowgrade extranodal marginal zone B cell lymphoma of mucosa-associated tissue of the lung (MALToma) based on results of a pathologic examination. Candida albicans was isolated from her left-side pleural effusion. Atypical lymphocytes with immunocytochemical anti- CD20 positivity were also isolated from her left-side pleural effusion. In tracing the patient's history, we found that the lesions had persisted for many years. Thus, we suggest MALToma is an indolent disease, but that any kind of infection will cause the MALToma condition to deteriorate.

並列關鍵字

pleural effusion ； pulmonary mucosa-associated lymphoid tissue lymphoma (P-MALToma) ； clarithromycin