目标:腮腺淋巴瘤(PGL)是一种罕见且具有挑战性的诊断。不同的淋巴瘤可以在腮腺发展,最常见的是粘膜相关淋巴组织(MALT)淋巴瘤,直接来源于腺体薄壁组织。其他组织学亚型来自腺内和腺外腮腺淋巴结。关于PGL的诊断和治疗仍缺乏共识,公布的数据是稀缺和异构的。
方法:我们对文献进行了系统回顾,包括2001年后发表的研究,当时引入了WHO对淋巴肿瘤的分类。
结果:分析包括20项回顾性研究,其中8只集中在MALT淋巴瘤。最终分析包括612例PGL,F/M比为1.68:1。MALT淋巴瘤是最常见的组织学,其次是滤泡性和弥漫性大B细胞淋巴瘤。大多数病例为低阶段(IE/IIEacc。安·阿伯,76.5%),只有10%的患者出现症状,最常见的疼痛(4.8%)和B症状(2.2%)。发现相关的自身免疫性疾病的患病率很高,尤其是干燥综合征,影响高达70%的MALT淋巴瘤患者。在大多数情况下,诊断是通过腮腺切除术(57.5%),或开放活检(31.2%)。治疗策略要么是手术,非手术或多种方式的组合。据报道,手术作为单一模式治疗的患者约有20%,假设它可能是一个有价值的选择选定的患者。
结论:我们的综述显示,PGLs的诊断和治疗远未标准化,需要进一步研究,更多同质的报告达成共识。
OBJECTIVE: Parotid gland lymphoma (PGL) is a rare and challenging diagnosis. Different lymphomas can develop in the parotid gland, with the most common being the mucosa-associated lymphoid tissue (MALT) lymphoma, which originates directly from the glandular parenchyma. Other histologic subtypes arise from both intraglandular and extraglandular parotid lymph nodes. A consensus on diagnosis and treatment of PGL is still lacking, and published data is scarce and heterogeneous.
METHODS: We performed a systematic review of the literature, including studies published after 2001, when the WHO classification of lymphoid tumours was introduced.
RESULTS: Twenty retrospective studies were included in the analyses, eight of which focused exclusively on MALT lymphomas. Final analysis included 612 cases of PGL, with a 1.68:1 F/M ratio. MALT lymphoma was the most common histology, followed by follicular and diffuse large B-cell lymphoma. Most cases were low stages (IE/IIE acc. Ann Arbour, 76.5%) and only 10% of patients presented with symptoms, most commonly pain (4.8%) and B symptoms (2.2%). A high prevalence of associated autoimmune diseases was found, particularly Sjögren\'s syndrome, that affected up to 70% of patients with MALT lymphoma. In most cases diagnosis was achieved through parotidectomy (57.5%), or open biopsy (31.2%). Treatment strategies were either surgical, non-surgical or a combination of modalities. Surgery as a single-modality treatment was reported in about 20% of patients, supposing it might be a valuable option for selected patients.
CONCLUSIONS: Our review showed that the diagnosis and treatment of PGLs is far from being standardized and needs further, more homogeneous reports to reach consensus.