Linfoma MALT de parótida, presentación de un caso clínico y revisión del tema / Parotid MALT lymphoma, presentation of a clinical case and review of subject

Los linfomas de las glándulas salivales son una entidad poco frecuente, estimándose una incidencia del 5 por ciento. La localización más habitual es la glándula parótida, seguida de la submaxilary la sublingual. La mayoría de los linfomas parotídeos son linfomas no Hodgkin (LNH) y se consideran derivados del tejido linfoide asociado a mucosas (MALT). Infrecuentemente se han reportado estos casos y suelen ser subdiagnosticados por su presentación relativamente benigna, comportándose de forma localizada, de lento crecimiento, con varios años de evolución. Presentamos un caso clínico de linfoma tipo MALT de parótida de acuerdo a las características clínicas, histológicas e inmunohistoquímicas de este tumor. Además una revisión de la literatura de este caso.

Lymphomas of the salivary glands are a rare entity, with an estimated incidence of 5 percent. The most frequent location is parotid gland, followed by the submandibular and sublingual. The majority of parotid lymphomas are non-Hodgkin's lymphoma NHL and are considered derived from mucosa-associated lymphoid tissue (MALT). Infrequently these cases have been reported and are often underdiagnosed for their presentation is relatively benign, localized behaving, slow growing, with several years of evolution. We report a case of parotid MALT lymphoma according to the clinical, histological and immunohistochemical characteristics of this tumor. In addition, a literature review of this case.

Evaluation of the sensitivity of the double-contrast upper gastrointestinal series in the diagnosis of gastric cancer.

OBJECTIVE: To evaluate the sensitivity, specificity and accuracy of the double-contrast upper gastrointestinal series (UGI series) in the diagnosis of gastric cancer. MATERIAL AND METHOD: The authors retrospectively reviewed the radiographs of the double-contrast UGI series for diagnosis of gastric cancer of 84 patients who had pathological confirmation by gastric biopsies and/or operations. RESULTS: The lesions were true positive in 45 patients, true negative in 28 patients, false positive in 8 patients and false nagative in 3 patients. The authors found pathologically proved gastric cancers in 48 patients. They were 42 adenocarcinomas (87.5%), 3 gastric mucosa-associated lymphoid tissue lymphomas (6.2%), one gastrointestinal stromal tumor (2.1%), one squamous cell carcinoma at the distal esophagus involving the cardia (2.1%) and one cancer of the pancreatic head with invading gastric antrum (2.1%). The sensitivity, specificity and accuracy of the present study were 93 per cent, 77 per cent and 86 per cent, respectively. They showed small differences compared to the previous studies. CONCLUSION: The present findings indicate that the double-contrast UGI series has high sensitivity, specificity and accuracy. It should be considered a sensitive technique and initial examination in the diagnosis of gastric cancer.

A Case of Primary Esophageal B-cell Lymphoma of MALT type, Presenting as a Submucosal Tumor

The primary esophageal lymphoma is extremely rare, and shows various morphologic characteristics. Only a single case of mucosa-associated lymphoid tissue (MALT) type lymphoma confined to the esophagus has been reported in the literature. A 61-yr-old man was referred to our hospital for evaluation of an esophageal submucosal tumor (SMT) that had been detected incidentally by endoscopy. He had a history of pulmonary tuberculosis with long-term anti-tuberculosis medication 15 yr before, and also had a history of syphilis, which had been treated one year before. He had been taking a synthetic thyroid hormones for the past 10 months because of an autoimmune thyroiditis. Endoscopy showed a longitudinal round and tubular shaped smooth elevated lesion, which was covered with intact mucosa and located at the mid to distal esophagus, 31 cm to 39 cm from the incisor teeth. Endoscopic ultrasonography (EUS) showed a huge longitudinal growing intermediate- to hypo-echoic mass located in the submucosal layer with internal small, various sized honeycomb-like anechoic lesions suggesting germinal centers. Subsequently, he underwent a surgery, which confirmed the mass as a primary esophageal low-grade B-cell lymphoma of MALT type.