Identification of Mucosa-Invading and Intravascular Bacteria in Feline Small Intestinal Lymphoma
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Persistent bacterial infections of the gastrointestinal mucosa are causally linked to gastric carcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma in people and laboratory animals. We examined the relationship of mucosa-associated bacteria to alimentary lymphoma in cats. Intestinal biopsies from 50 cats with alimentary lymphoma (small cell, n = 33; large cell, n = 17) and 38 controls without lymphoma (normal to minimal change on histopathology, n = 18; lymphocytic-plasmacytic enteritis, n = 20) were evaluated. The number and spatial distribution of bacteria (ie, in luminal cellular debris, villus-associated mucus, adherent to epithelium, mucosal invasion, intravascular, or serosal) were determined by fluorescence in situ hybridization with the eubacterial probe EUB-338. Mucosa-invasive bacteria were more frequently observed in cats with large cell lymphoma (82%, P ≤ .001) than in cats with small cell lymphoma (18%), normal to minimal change on histopathology, and lymphocytic-plasmacytic enteritis (3%). Intravascular bacteria were observed solely in large cell lymphoma (29%), and serosal colonization was more common in cats with large cell lymphoma (57%) than with small cell lymphoma (11%, P ≤ .01), normal to minimal change (8%, P ≤ .01), and lymphocytic-plasmacytic enteritis (6%, P ≤ .001). The high frequency of invasive bacteria within blood vessels and serosa of cats with large cell lymphoma may account for the sepsis-related complications associated with large cell lymphoma and inform clinical management. Further studies are required to determine the role of intramucosal bacteria in the etiopathogenesis of feline alimentary lymphoma.Keywords:
Histopathology
Mucosa-associated lymphoid tissue
Intestinal mucosa
Mucosa-associated lymphoid tissue
Chemosis
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Objective: To investigate the pathological features and clinical manifestations of mucosa-associated lymphoid tissue (MALT) lymphoma in children and adolescents. Methods: Five cases of MALT lymphoma in children were investigated by morphology and immunophenotyping along with clinical follow-up. Results: Five cases of MALT lymphoma occurred in the antrum, orbit, parotid gland and nasopharynx. All patients had no B symptoms and only one patient showed a local mass with ulcer. One case presented with cervical lymph node enlargement, and 4 cases showed no evidence of lymphadenopathy.All cases had pathological features similar to those of adult MALT lymphoma, with proliferation of monocytoid B cells orcentralcyte-like tumor cells, with plasma cell differentiation and lymphoid epithelial lesions.No specific immunophenotypic marker was found. Clonal Ig gene rearrangement was detected in two cases.One patient was treated with rituximab treatment, 1 patient was given anti-Helicobacter pylori therapy, and 2 patients had no additional treatment.The follow-up data showed that 4 patients survived without tumor recurrence. Conclusions: Similar to adult patients, MALT lymphoma in children and adolescents has similar pathological features with indolent clinical course and good prognosis. It is important to note that misdiagnosis and incorrect diagnosis mightoccur because of the young age of the patients.目的： 探讨儿童青少年黏膜相关淋巴组织结外边缘区(MALT)淋巴瘤的病理特征及临床表现。 方法： 观察5例儿童青少年MALT淋巴瘤镜下形态及免疫表型，并进行临床随访。 结果： (1)5例MALT淋巴瘤分别发生在胃窦、眼眶、腮腺及鼻咽部，患者均无B症状，仅表现为局部肿块和溃疡，其中1例伴有颈部淋巴结肿大，余4例均无淋巴结肿大。(2)5例均具有成人MALT淋巴瘤的病理特征，细胞形态表现为单核样B细胞或中心细胞样细胞，伴有浆细胞分化(2/5)，可见滤泡植入及淋巴上皮病变(3/5)。(3)免疫表型没有特异性的标志物，需综合诊断。(4)2例免疫球蛋白(Ig)基因重排检测阳性。(5)4例得到随访，1例予利妥昔单抗治疗，1例服用抗幽门螺杆菌药物治疗，2例未进一步治疗。4例均生存，且未见复发。 结论： 儿童青少年MALT淋巴瘤具有成人MALT淋巴瘤相似的病理特征及惰性的临床经过，预后较好。但由于患者发病年龄低，常容易误诊及漏诊。.
Mucosa-associated lymphoid tissue
Immunophenotyping
Gene rearrangement
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Mucosa-associated lymphoid tissue (MALT) lymphoma is among the most common forms of extranodal lymphomas, but little is known about subcutaneous involvement in patients with non-primary cutaneous marginal zone lymphomas.Patients with MALT lymphoma diagnosed and treated at our institution between 1999 and 2010 were analyzed for subcutaneous deposits from MALT lymphoma diagnosed in another organ. Histological, clinical and genetic findings were assessed.Among 216 patients with MALT lymphoma, 12 had subcutaneous deposits from MALT lymphoma (5.5%). In two patients, these lesions were present at diagnosis, while they constituted the site of relapse at an interval between 5 to 144 months in the remaining cases. Interestingly, nine of the 12 patients with subcutaneous deposits had originally been diagnosed with MALT lymphoma of the ocular adnexa (total number=51; 20%), and the other three had MALT lymphoma in the breast (total number=5; 60%). None of the patients with gastric (n=86), salivary gland (n=32) or pulmonary (n=19) MALT lymphomas had subcutaneous involvement during a median follow-up time of 87 months (range; 4 to 119 months).Our data show that subcutaneous MALT lymphoma involvement is a rare event in patients with prior non-cutaneous extranodal marginal zone lymphoma. However, it seems to be almost exclusively associated with MALT lymphoma of the ocular adnexa and the breast, suggesting as yet undefined interactions between potentially embryonically related organ systems.
Mucosa-associated lymphoid tissue
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Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) of pulmonary origin is a relatively rare disease. In particular, reports of MALT lymphoma occurring and localized in the trachea or bronchus have been limited. Pulmonary MALT lymphoma has been reported to demonstrate spontaneous regression, whereas there is only one reported case of spontaneous regression of primary endobronchial MALT lymphoma. We herein report the case of a 70-year-old man with primary endobronchial MALT lymphoma who showed spontaneous regression with an interest of endobronchial findings.
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We describe marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) and especially MALT lymphoma occurring in the conjunctiva. Tumors of the conjunctiva and cornea are grouped into two major categories of congenital and acquired lesions. Lymphoid tumors of the conjunctiva are acquired tumors and can occur as an isolated lesion or can be a manifestation of systemic lymphoma. Primary lymphomas of the conjunctiva are extremely rare usually originate from extranodal marginal zone B-cell non-Hodgkin's lymphomas of MALT and occur among older adults with a mean age of 61 years. In the last decade it has been reported that MALT lymphomas may develop in various extraintestinal locations, sometimes even without the presence of a mucosa. Half of MALT lymphomas occur in the gastrointestinal tract. MALT lymphomas of the eye are rare and originate from the conjunctiva and the lacrimal glands. Studies evaluating the clinical impact of 67Ga-C scintigraphy for MALT-type lymphomas imaging are rare, based on small numbers, heterogenous groups of patients. Clinical examination, excisional biopsy, histopathology and immunohistochemical studies, computerized tomography and magnetic resonance imaging are also used for the diagnosis of cunjunctival MALT disease. A case of ours gives reason for further discussion. Treatment and follow-up of MALT lymphoma is described.
Mucosa-associated lymphoid tissue
Histopathology
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Mucosa-associated lymphoid tissue
Lymphoid hyperplasia
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Histologic features of low-grade gastric lymphomas of mucosa-associated lymphoid tissue (MALT) have been extensively described, and transformation to a large cell (high-grade) lymphoma can occur. We characterize high-grade gastric lymphoma histologically in an attempt to distinguish between MALT-type and non-MALT-type lesions. We studied a series of 60 gastric lymphomas and characterized them clinically, histopathologically, and immunophenotypically. Low-grade gastric lymphomas were classified according to established criteria. High-grade lymphomas were classified in three groups based on the presence or absence of a low-grade component and lymphoepithelial lesions (LELs): 1) high-grade MALT lymphomas appearing in low-grade MALT lymphomas (LG/HG MALT lymphoma); 2) large cell lymphoma with LELs composed of large cells (high-grade LELs) but without a low-grade component (HG MALT lymphoma); and 3) diffuse large cell lymphoma without a low-grade MALT lymphoma component or LELs (DLCL). Twenty-two lymphomas were classified as low-grade MALT lymphomas, 16 as LG/HG MALT lymphomas, 10 as HG MALT lymphomas, and 12 as DLCL. B-cell immunophenotype was confirmed in all 55 cases in which immunophenotyping was performed. Low-grade LELs were seen in all low-grade MALT lymphomas, and CD20(L26) expression confirmed B-cell phenotype in the LELs in 20 of 20 cases. Clinical follow-up was available for 56 patients (range, 1-264 months; mean, 57 months). Actuarial analysis of disease-specific survival and relapse-free survival showed that clinical stage was highly statistically significant (P < 0.0001), whereas histologic type and grade approached statistical significance. Multivariate analysis showed that clinical stage was the only significant factor in relapse-free and disease-specific survival.
Mucosa-associated lymphoid tissue
Immunophenotyping
Gastric lymphoma
Large cell
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Primary pulmonary lymphoma (PPL) mainly comprises mucosa-associated lymphoid tissue (MALT) lymphoma as well as other subtypes of lymphoma. Different phenotypes of PPL demonstrate various high-resolution computed tomography (HRCT) features. We aimed to evaluate the value of HRCT in the diagnosis and differential diagnosis of PPL, especially between MALT lymphoma and non-MALT lymphoma and the correlation between CT and pathological features.We performed a retrospective analysis on 72 patients with PPL confirmed by pathology between 2007 and 2016. We compared the CT characteristics and correlation with pathological findings between MALT lymphoma and non-MALT lymphoma groups.All 72 patients with PPL were classified into two groups: low-grade MALT lymphoma (MALToma) (56/72) and high-grade non-MALT lymphoma (non-MALToma) (16/72). The latter group consisted of diffuse large B cell lymphoma (8/72), Hodgkin's lymphoma (3/72), T-cell lymphoma (4/72), and intravascular large B-cell lymphoma (1/72). A total of 168 lesions were analyzed, including 57 cases with multiple lesions and 15 cases with single lesion. The manifestation of four distribution patterns: nodular or mass-like involvement pattern, diffuse interstitial lung disease (DILD) pattern, pneumonia-like consolidative pattern and mixed pattern was not significantly different between MALToma and non-MALToma (all P>0.05). Signs of air bronchogram and CT angiogram occurred significantly more often in individuals with MALToma group than those with non-MALToma (75% vs. 25%, P=0.001; 64.3% vs. 12.5%, P<0.001; respectively). Conversely, the halo sign presented more often in non-MALToma than in MALToma patients (19% vs. 63.6%, P=0.02). In addition, the butterfly sign was only observed in four patients with MALToma.HRCT imaging phenotypes were beneficial in the diagnosis of PPL. Solitary or multifocal nodules/masses and consolidation were the most common imaging patterns. The air bronchogram sign, CT angiogram sign, halo sign, and butterfly sign could be potential to help to differentiate MALToma from non-MALToma.
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Mucosa associated lymphoid tissue (MALT) lymphoma is a lymphoid neoplasm arising in extranodal sites with histologic features similar to those of nodal marginal zone lymphoma. Among the sites where a primary MALT lymphoma arises, the GI tract is the most common whereas the breast represents only 4%. Bilateral involvement of the breasts by a primary MALT lymphoma is exceptional with only 10 cases reported in the literature up to date. Herein, a case of a 73 years old woman with bilateral breast involvement by MALT lymphoma is presented and discussed.
Mucosa-associated lymphoid tissue
Neoplasm
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