以铺路石征为表现的原发性肺黏膜相关淋巴组织淋巴瘤一例并文献复习_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

陈露露 ¹ ,  代静泓 ¹ , 刘寅 ¹ , 丁晶晶 ¹ , 肖永龙 ¹ , 蔡后荣 ¹ , 樊祥山 ²

1. ;
2. ;

Corresponding author：

代静泓, Email: 23568@sina.com

Keywords：

原发性肺黏膜相关淋巴组织淋巴瘤; 铺路石征

DOI：

10.7507/1671-6205.201903066

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目的探讨以铺路石征为影像学特点的原发性肺黏膜相关淋巴组织（MALT）淋巴瘤的临床表现、影像学特点及其病理基础。方法回顾 1 例 MALT 淋巴瘤患者的临床表现、影像学特点及病理资料，结合有关文献进行回顾性分析，以“原发性肺黏膜相关淋巴组织淋巴瘤”、“铺路石征”以及“pulmonary lymphoma”和“crazy-paving pattern”为检索词在万方、维普、中国知网及 Pubmed 等数据库以进行检索相关文献并进行分析。结果患者，男，51 岁。慢性病程，CT 表现为逐渐进展的小叶间隔增厚，呈“铺路石”样改变，伴有局部实变及支气管充气征，最终经皮肺穿刺活检明确诊断。复习 6 例国内外文献报道，仅 1 例 CT 表现为左肺下叶背段局限性“铺路石征”，肺叶切除病理确诊为肺 MALT 淋巴瘤，其余 4 例为血液病继发肺泡蛋白沉积症（PAP），CT 表现为“铺路石征”，1 例为 PAP 合并淋巴瘤。结论 MALT 淋巴瘤患者高分辨 CT 以铺路石征为主要表现较为罕见，容易误诊为肺泡蛋白沉积症。掌握铺路石征在各种疾病中出现的部位、特点及影像学表现，结合临床表现及经支气管镜或经皮肺活检，有助于明确诊断，降低误诊率。

Citation： 陈露露, 代静泓, 刘寅, 丁晶晶, 肖永龙, 蔡后荣, 樊祥山. 以铺路石征为表现的原发性肺黏膜相关淋巴组织淋巴瘤一例并文献复习. 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.	诸兰艳, 吴庆华, 陈平. 肺泡蛋白沉积症合并淋巴瘤一例. 中南大学学报 (医学版), 2004, 29(1): 120-121.
4.	陈露露, 田亚琼, 张英为, 等. 继发于血液系统疾病的肺泡蛋白沉积症三例报告及文献复习. 中国呼吸与危重监护杂志, 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.	张艳, 余建群, 朱洪基, 等. 肺黏膜相关淋巴组织淋巴瘤的 CT 和临床表现及其病理学基础. 放射学实践, 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.	陈淮, 曾庆思, 伍筱梅, 等. 肺黏膜相关淋巴组织淋巴瘤的 CT 及 PET-CT 表现. 临床放射学杂志, 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. 诸兰艳, 吴庆华, 陈平. 肺泡蛋白沉积症合并淋巴瘤一例. 中南大学学报 (医学版), 2004, 29(1): 120-121.
4. 陈露露, 田亚琼, 张英为, 等. 继发于血液系统疾病的肺泡蛋白沉积症三例报告及文献复习. 中国呼吸与危重监护杂志, 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. 张艳, 余建群, 朱洪基, 等. 肺黏膜相关淋巴组织淋巴瘤的 CT 和临床表现及其病理学基础. 放射学实践, 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. 陈淮, 曾庆思, 伍筱梅, 等. 肺黏膜相关淋巴组织淋巴瘤的 CT 及 PET-CT 表现. 临床放射学杂志, 2015, 34(4): 548-551.

Chinese Journal of Respiratory and Critical Care Medicine

以铺路石征为表现的原发性肺黏膜相关淋巴组织淋巴瘤一例并文献复习

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