| Objective:The purpose of this essay is, by analyzing and summarizing the clinical manifestation, endoscopic features, histopathological and immunohistochemical lymphoma of gastric mucosa associated lymphoid tissue(MALT), to improve the early diagnosis rate of this disease, and to guide its early clinical treatment.Methods:Reviewing 24 cases of gastroscopy, pathological biopsy, immunohistochemistry been diagnosed as gastric mucosa associated lymphoid tissue lymphoma, which were collected from the No.1 Affiliated Hospital of Zunyi Medical College and Zunyi City Hospital from 2004 to 2014, as the research object. To analyze the clinical and endoscopic, pathological and immunohistochemical features of the disease through collecting the age, gender, symptoms, endoscopic findings, histopathological and immunohistochemical results of the patients.Results:1. General information:16 cases of male and 8 of female, ranging from 18 to 76 years old, with the average age of 60.5 years old,has 19 cases(79.1%) between 40-70 years old.2. Clinical manifestation:All patients performed no specific clinical manifestations to different degrees, with upper abdominal pain as the most common performance; some patients manifested as abdominal distension, loss of appetite, weight loss, gastrointestinal bleeding, anemia etc.3. Endoscopic performance:the lesions of Gastric MALT lymphoma were wide and with morphological diversity, and it involved in multiple parts of the stomach and even the duodenum, occurring in the body of stomach most, and took the same proportion of at least 2 parts of the gastric antrum, gastric body and fundus of stomach angle involved; the manifestations of gastric MALT lymphoma under endoscope may be ulcers, erosions, nodular eminence, mucous membrane thick, polyps, in which ulcer was the most common one, and all of those existed at the same time.4. Histological features and immunohistochemical staining: the pathological features of this disease under microscope were CCL cell, plasma cell differentiation, lymphoepithelial lesion, and home phenomenon. Immunohistochemical staining showed that CD20 andCD79a were positive, CD45 RO, CK negative, Ki-67 proliferating cell index. The higher index was, the faster the growth of tumor cell differentiating.Conclusion:Gastric MALT lymphoma occurred commonly at the age of 40 to 70, with more males than females in a ratio of 2:1, and with no characteristic clinical manifestation. Endoscopic lesions occurred mostly in the body of stomach, with ulcers as the most common type and featured in multifocal, polymorphism. Histopathology and immunohistochemistry was the golden standard in the diagnosis of the disease, and the pathological endoscopic manifestation could be summarized as plasma cell differentiation, CCL cells, lymphoepithelial lesion, and the phenomenon of home. Cell marker CD20, CD79 a of Immunohistochemical B were all positive, suggesting the source of B lymphocyte; T cell surface marker protein CD45 RO were all negative; Epithelial marker protein CK were all negative; the higher the Ki-67 index, the greater the degree of malignancy. Gastric MALT lymphoma was more likely to the submucosal lesions. Superficial and too small of mucosal biopsy tissue, pathological biopsy tissue extruding deformation may cause the low positive rate of biopsy, and often need repeated endoscopy and biopsy, or even been confirmed after operation, which make it difficult for early diagnosis and treatment. But the disease can be treated by anti-Hp therapy in the early stage and can be relieved. Therefore, the improvement of the awareness of the disease and the rate of early diagnosis is important. |
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