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目的:探讨肺MALT型淋巴瘤的病因、病理、诊断、治疗等问题,以提高临床医师对肺MALT型淋巴瘤的认识。方法:对华西医院4例完整的肺MALT型淋巴瘤的临床资料进行回顾性分析。结果:女性2例,男性2例,年龄33～70岁,中位年龄42岁。临床表现:咳嗽2例,痰中带血1例,呼吸困难2例,体重下降1例,听力下降1例,体检发现1例。胸部CT表现:单一肿块型2例,肺实变型2例。确诊手段:1例纤维支气管镜活检,2例开胸活检,1例经皮肺穿刺取活检。治疗包括手术、利妥昔单抗为主的联合化疗、干扰素等。患者中位随访时间28个月(10～92个月),均存活。结论:肺MALT型淋巴瘤是一独特亚型,临床表现不典型,影像学无特异性,诊断主要依靠病理活检。治疗尚无共识,主要有手术、化疗、放疗、生物治疗等。
Objective: To explore the etiology, pathology, diagnosis and treatment of pulmonary MALT lymphoma and to raise the awareness of clinicians on pulmonary MALT lymphoma. Methods: The clinical data of 4 complete lung MALT lymphoma in West China Hospital were retrospectively analyzed. Results: 2 females, 2 males, aged 33 to 70 years, with a median age of 42 years. Clinical manifestations: 2 cases of cough, bloody sputum 1 case, 2 cases of dyspnea, weight loss in 1 case, hearing loss in 1 case, physical examination found in 1 case. Chest CT manifestations: a single mass in 2 cases, 2 cases of lung consolidation. Diagnostic methods: 1 case of bronchofibroscopy, 2 cases of thoracotomy, 1 case of percutaneous lung biopsy. Treatment includes surgery, rituximab-based combination chemotherapy, interferon and the like. The median follow-up time was 28 months (range, 10-92 months) and survived. Conclusions: Lung MALT lymphoma is a unique subtype, its clinical manifestations are not typical and imaging is nonspecific. The diagnosis mainly depends on pathological biopsy. There is no consensus on the treatment, mainly surgery, chemotherapy, radiotherapy, biological treatment.