以鋪路石征為表現的原發性肺黏膜相關淋巴組織淋巴瘤一例并文獻復習_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

陳露露 ¹ ,  代靜泓 ¹ , 劉寅 ¹ , 丁晶晶 ¹ , 肖永龍 ¹ , 蔡后榮 ¹ , 樊祥山 ²

1. ;
2. ;

Corresponding?author：

代靜泓, Email: 23568@sina.com

Keywords：

原發性肺黏膜相關淋巴組織淋巴瘤; 鋪路石征

DOI：

10.7507/1671-6205.201903066

Video：

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目的探討以鋪路石征為影像學特點的原發性肺黏膜相關淋巴組織（MALT）淋巴瘤的臨床表現、影像學特點及其病理基礎。方法回顧 1 例 MALT 淋巴瘤患者的臨床表現、影像學特點及病理資料，結合有關文獻進行回顧性分析，以“原發性肺黏膜相關淋巴組織淋巴瘤”、“鋪路石征”以及“pulmonary lymphoma”和“crazy-paving pattern”為檢索詞在萬方、維普、中國知網及 Pubmed 等數據庫以進行檢索相關文獻并進行分析。結果患者，男，51 歲。慢性病程，CT 表現為逐漸進展的小葉間隔增厚，呈“鋪路石”樣改變，伴有局部實變及支氣管充氣征，最終經皮肺穿刺活檢明確診斷。復習 6 例國內外文獻報道，僅 1 例 CT 表現為左肺下葉背段局限性“鋪路石征”，肺葉切除病理確診為肺 MALT 淋巴瘤，其余 4 例為血液病繼發肺泡蛋白沉積癥（PAP），CT 表現為“鋪路石征”，1 例為 PAP 合并淋巴瘤。結論 MALT 淋巴瘤患者高分辨 CT 以鋪路石征為主要表現較為罕見，容易誤診為肺泡蛋白沉積癥。掌握鋪路石征在各種疾病中出現的部位、特點及影像學表現，結合臨床表現及經支氣管鏡或經皮肺活檢，有助于明確診斷，降低誤診率。

Citation： 陳露露, 代靜泓, 劉寅, 丁晶晶, 肖永龍, 蔡后榮, 樊祥山. 以鋪路石征為表現的原發性肺黏膜相關淋巴組織淋巴瘤一例并文獻復習. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(6): 573-576. doi: 10.7507/1671-6205.201903066 Copy

1.	Fujita M, Uchino J, Nabeshima K, et al. Pulmonary MALT lymphoma demonstrating a crazy-paving appearance on imaging. Intern Med, 2015, 54(20): 2705-2706.
2.	Fraser T, Nagarur A. Pulmonary involvement of peripheral T-cell lymphoma manifesting as crazy paving pattern. Proc (Bayl Univ Med Cent), 2015, 28(1): 59-61.
3.	諸蘭艷, 吳慶華, 陳平. 肺泡蛋白沉積癥合并淋巴瘤一例. 中南大學學報 (醫學版), 2004, 29(1): 120-121.
4.	陳露露, 田亞瓊, 張英為, 等. 繼發于血液系統疾病的肺泡蛋白沉積癥三例報告及文獻復習. 中國呼吸與危重監護雜志, 2015, 14(6): 588-591.
5.	Borie R, Wislez M, Thabut G, et al. Clinical characteristics and prognostic factors of pulmonary MALT lymphoma. Eur Respir J, 2009, 34(6): 1408-1416.
6.	Chng WJ, Remstein ED, Fonseca R, et al. Gene expression profiling of pulmonary mucosa-associated lymphoid tissue lymphoma identifies new biologic insights with potential diagnostic and therapeutic applications. Blood, 2009, 113(3): 635-645.
7.	Borie R, Wislez M, Antoine M, et al. Pulmonary mucosa-associated lymphoid tissue lymphoma revisited. Eur Respir J, 2016, 48(4): 1252.
8.	Borie R, Wislez M, Antoine M, et al. Clonality and phenotyping analysis of alveolar lymphocytes is suggestive of pulmonary MALT lymphoma. Respir Med, 2011, 105(8): 1231-1237.
9.	Oh SY, Kim WS, Kim JS, et al. Stage Ⅳ marginal zone B-cell lymphoma--prognostic factors and the role of rituximab: Consortium for Improving Survival of Lymphoma (CISL) study. Cancer Sci, 2010, 101(11): 2443-2447.
10.	Cordier JF, Chailleux E, Lauque D, et al. Primary pulmonary lymphomas. A clinical study of 70 cases in nonimmunocompromised patients. Chest, 1993, 103(1): 201-208.
11.	Feng Y, Zhao J, Yang Q, et al. Pulmonary melanoma and "crazy paving" patterns in chest images: a case report and literature review. BMC Cancer, 2016, 16: 592.
12.	張艷, 余建群, 朱洪基, 等. 肺黏膜相關淋巴組織淋巴瘤的 CT 和臨床表現及其病理學基礎. 放射學實踐, 2016, 31(8): 734-738.
13.	Zhang WD, Guan YB, Li CX, et al. Pulmonary mucosa-associated lymphoid tissue lymphoma: computed tomography and (1)(8)F fluorodeoxyglucose-positron emission tomography/computed tomography imaging findings and follow-up. J Comput Assist Tomogr, 2011, 35(5): 608-613.
14.	陳淮, 曾慶思, 伍筱梅, 等. 肺黏膜相關淋巴組織淋巴瘤的 CT 及 PET-CT 表現. 臨床放射學雜志, 2015, 34(4): 548-551.

1. Fujita M, Uchino J, Nabeshima K, et al. Pulmonary MALT lymphoma demonstrating a crazy-paving appearance on imaging. Intern Med, 2015, 54(20): 2705-2706.
2. Fraser T, Nagarur A. Pulmonary involvement of peripheral T-cell lymphoma manifesting as crazy paving pattern. Proc (Bayl Univ Med Cent), 2015, 28(1): 59-61.
3. 諸蘭艷, 吳慶華, 陳平. 肺泡蛋白沉積癥合并淋巴瘤一例. 中南大學學報 (醫學版), 2004, 29(1): 120-121.
4. 陳露露, 田亞瓊, 張英為, 等. 繼發于血液系統疾病的肺泡蛋白沉積癥三例報告及文獻復習. 中國呼吸與危重監護雜志, 2015, 14(6): 588-591.
5. Borie R, Wislez M, Thabut G, et al. Clinical characteristics and prognostic factors of pulmonary MALT lymphoma. Eur Respir J, 2009, 34(6): 1408-1416.
6. Chng WJ, Remstein ED, Fonseca R, et al. Gene expression profiling of pulmonary mucosa-associated lymphoid tissue lymphoma identifies new biologic insights with potential diagnostic and therapeutic applications. Blood, 2009, 113(3): 635-645.
7. Borie R, Wislez M, Antoine M, et al. Pulmonary mucosa-associated lymphoid tissue lymphoma revisited. Eur Respir J, 2016, 48(4): 1252.
8. Borie R, Wislez M, Antoine M, et al. Clonality and phenotyping analysis of alveolar lymphocytes is suggestive of pulmonary MALT lymphoma. Respir Med, 2011, 105(8): 1231-1237.
9. Oh SY, Kim WS, Kim JS, et al. Stage Ⅳ marginal zone B-cell lymphoma--prognostic factors and the role of rituximab: Consortium for Improving Survival of Lymphoma (CISL) study. Cancer Sci, 2010, 101(11): 2443-2447.
10. Cordier JF, Chailleux E, Lauque D, et al. Primary pulmonary lymphomas. A clinical study of 70 cases in nonimmunocompromised patients. Chest, 1993, 103(1): 201-208.
11. Feng Y, Zhao J, Yang Q, et al. Pulmonary melanoma and "crazy paving" patterns in chest images: a case report and literature review. BMC Cancer, 2016, 16: 592.
12. 張艷, 余建群, 朱洪基, 等. 肺黏膜相關淋巴組織淋巴瘤的 CT 和臨床表現及其病理學基礎. 放射學實踐, 2016, 31(8): 734-738.
13. Zhang WD, Guan YB, Li CX, et al. Pulmonary mucosa-associated lymphoid tissue lymphoma: computed tomography and (1)(8)F fluorodeoxyglucose-positron emission tomography/computed tomography imaging findings and follow-up. J Comput Assist Tomogr, 2011, 35(5): 608-613.
14. 陳淮, 曾慶思, 伍筱梅, 等. 肺黏膜相關淋巴組織淋巴瘤的 CT 及 PET-CT 表現. 臨床放射學雜志, 2015, 34(4): 548-551.

Chinese Journal of Respiratory and Critical Care Medicine

以鋪路石征為表現的原發性肺黏膜相關淋巴組織淋巴瘤一例并文獻復習

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