| 胃肠道浆母细胞型淋巴瘤临床病理特点分析 |
| 投稿时间：2014-05-28 修订日期：2014-06-23 点此下载全文 |
| 引用本文：魏建国,袁晓露,刘文英,孙爱静.胃肠道浆母细胞型淋巴瘤临床病理特点分析[J].医学研究杂志,2015,44(1):80-83 |
| DOI：
10.3969/j.issn.1673-548X.2015.01.023 |
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| 基金项目:浙江省医学扶植重点建设学科计划(GJSX-010-004) |
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| 中文摘要:目的 探讨胃肠道浆母细胞型淋巴瘤(plasmablaslic lymphoma,PBL)的临床病理特点、诊断及鉴别诊断、治疗和预后。方法 回顾性分析5例发生在胃肠道的浆母细胞型淋巴瘤的临床资料、病理形态特点及免疫表型特征,并结合相关文献复习。结果 患者平均年龄67.6岁,男女性别比例为4:1,1例位于胃,2例位于直肠,2例位于结肠。肿块多位于黏膜层至黏膜下层,并侵至肌层。5例PBL镜下形态相似,浆细胞样分化的异型淋巴细胞在黏膜层及肌层中弥漫浸润性生长,瘤细胞圆形或椭圆形,胞质丰富,核仁大而明显,核偏位,核分裂象易见,并可见凋亡小体和吞噬可染小体的巨噬细胞。免疫组化示CD138和CD38均弥漫阳性,CD79a局灶阳性;Ki-67增殖指数在80%以上,均存在κ或λ单链限制性表达,3例原位杂交EBER阳性。随访3~12个月,4例因肿瘤复发或转移死亡,1例失访。结论 胃肠道PBL是一种非常罕见的、高度侵袭性的B细胞来源的非霍奇金淋巴瘤,生存期较短,预后极差。本组5例病例,其中3例检测出EB病毒,推测其发生可能与EB病毒感染或者老年患者免疫功能低下有关。 |
| 中文关键词:胃肠道 浆母细胞型淋巴瘤 EB病毒 |
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| Clinicopathologic Features of Gastroinestinal Tractplasmablastic Lymphoma |
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| Abstract:Objective To investigate the clinicopathological features,diagnosis and differential diagnosis,treatment and prognosis of plasmablaslic lymphoma in the gastrointestinal tract. Methods The clinical data, histological features and immunohistochemical profiles were studied in 5 cases of plasmablaslic lymphoma in the gastrointestinal tract, with the review of the literatures. Results The average age of the patients was 67.6 years old. The male/female ratio was 4:1.One case with PBL of the gastrointestinal tract were found in stomach, two cases in rectum,and two cases in colon. The tumors typically involved the mucosa,submucosa,and infiltration into the muscular layer. 5 cases of PBL were similar in morphology. Plasmacytoid differentiation malignant lymphoid cells were diffusely infiltrated between muscosa layer and muscle layer.The tumor cells were round or oval,and abundant cytoplasm, big nucleolus and prominent nucleoli,nuclear deviation, mitoses were easy to be seen.Apoptotic bodies and phagocytic tingible body macrophages were also can be seen. Immunohistochemically,the tumor cells were diffusely positive for CD138 and CD38,partly positive for CD79a.Ki-67 proliferation index was more than 80%, and showed kappa-light chain or lambda-light chain restricted expression.In situ hybridization for Epstein-Barr Virus-encoded RNA (EBER) was positive in three cases. Four patients died of tumor recurrence or metastasis after being followed up for 3-12 months,and one patient was lost to be followed up. Conclusion PBL of gastrointestinal is a very rare, highly aggressive non-Hodgkin B cell lymphoma,with worse outcome and shorter survival period.EBV infection were detected in three patient,so we hypothesized that PBL may be related to EB virus infection or immune dysfunction in elderly patients. |
| keywords:Gastrointestinal Plasmablastic lymphoma EBV |
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