摘要
Abstract
Primary hepatic mucosa-associated lymphoid tissue(MALT)lymphoma is an extremely rare subtype of primary hepatic lymphoma(PHL),accounting for only 3%of all PHL cases.It is classified as a low-grade,indolent B-cell non-Hodgkin lymphoma.This lymphoma typically arises in MALT,with the stomach being the most commonly involved site.Cases of primary hepatic origin are exceptionally rare,both domestically and internationally.The etiology remains unclear,it is generally believed to be associated with chronic inflammation and persistent immune stimulation.Potential contributing factors include infections such as hepatitis B virus(HBV),hepatitis C virus(HCV),and Treponema pallidum(the causative agent of syphilis),as well as autoimmune diseases like Sjögren's syndrome.The core mechanism underlying its development and progression is the clonal expansion of B cells driven by the combined effects of multiple aforementioned factors.The clinical manifestations of primary hepatic MALT lymphoma lack specificity.Imaging examinations may detect space-occupying lesions in the liver,which are easily confused with other liver tumors.A definitive diagnosis relies on pathological examination and immunohistochemical staining.Currently,there is no clear clinical guideline for the diagnosis and treatment of MALT,and individualized treatment strategies are adopted in clinical practice.These strategies include regular observation,surgical resection,chemotherapy,radiotherapy,immunotherapy,and targeted therapy.Among them,complete surgical resection of early-stage localized lesions can achieve favorable therapeutic outcomes.This article reports a case of a 73-year-old female patient who was admitted to the hospital due to"epigastric pain for 4 months".She had a medical history of hypertension.Examinations revealed HBV infection and Treponema pallidum infection,and imaging studies showed a space-occupying lesion in segment 4 of the liver.After a multidisciplinary discussion,the patient underwent hepatic segment resection(segment Ⅳa+part of segment Ⅲ).Postoperative pathology confirmed the diagnosis of primary hepatic MALT lymphoma.The patient refused further chemotherapy,targeted therapy,and immunotherapy after surgery.Up to now,no recurrence has been observed during regular follow-up examinations.This case aims to enhance clinicians'awareness of this rare disease,facilitate accurate diagnosis and appropriate treatment,and prevent misdiagnosis with other liver conditions in clinical practice.关键词
原发性肝脏淋巴瘤/黏膜相关淋巴组织/病因/治疗Key words
primary hepatic lymphoma/mucosa-associated lymphoid tissue/etiology/treatment分类
医药卫生
