腮腺原發性淋巴瘤－病例報告

腮腺原發性淋巴瘤是一種少見的唾液腺惡性腫瘤，臨床症狀以腮腺部位之漸進性腫塊為主，病理絕大多數為非何金杰氏、B細胞淋巴瘤。本文報告1例71歲女性病患，因發現左側耳下有一逐漸增大的腫塊而至本科就診，經全腮腺切除手術證實為起源於黏膜關連性淋巴組織之高惡性度、廣泛性、大型B細胞淋巴瘤。病患術後接受2次化學治療，追蹤起今14個月並無局部復發或遠處轉移。起源於黏膜關連性淋巴組織之腮腺淋巴瘤有低惡性度、也有高惡性度，但以低惡性度較為常見。此種淋巴瘤之臨床過程較為惰性，且經常與慢性免疫唾液腺炎有關，因此相對於淋巴結性淋巴瘤而言，黏膜關連性淋巴組織淋巴瘤常可治療，鑑別二者實具相當臨床意義！本病例為高惡性度淋巴瘤，起源於腮腺之黏膜關連性淋巴組織，由於此病較為罕見，而見臨床表現與其他腮腺腫瘤難以區別，因此很少會先下這個診斷。

關鍵字

淋巴瘤；腮腺；黏膜關連性淋巴組織

並列摘要

Primart lymphoma of the parotid gland is a rare salivary gland malignancy. The most comon clinical manifestation is a progressively enlarging mass over the parotid area. The majority of parotid lymphomas are non-Hodgkin type and of B-cell origin. We describe a 71-year-old woman admitted to our department because of a progressively enlarging mass over the left parotid area. After total parotidectomy, tissue pathology identified a high grade, diffuse, large B cell lymphoma originating from mucosa associ-ated lymphoid tissue(MALT). The patient was discharged and underwent two coureses of chemotherapy. Over 14 months of follow-up, no regional recurrence or distant metas-tases have been found. Parotid lymphomas originating from MALT appear to be either liow grade or high grade, with most tending to be low grade. They have an indolent clini-cal coutse,and are ferquently associated with chronic immunosialoadenitis. In contrast to nodal lymphomas, MALT lymphomas are often curable. Clinically, it is important to differentiate parotid MALT lymphomas from parotid nodal lymphomas. The high grade lymphoma found in this patient originating from MALT of the parotid gland is an entity that is rarely suspected clinically.

並列關鍵字

lymphoma ； parotid gland ； mucosa associated lymphoid tissue ； MALT

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腮腺原發性淋巴瘤－病例報告

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