扁桃体非霍奇金淋巴瘤的临床病理及分型的研究

目的 探讨扁桃体非霍奇金淋巴瘤的临床表现、病理组织形态、免疫表型的特点及分型。方法 收集1998年1月-2004年9月36例扁桃体非霍奇金淋巴瘤活检病例的临床资料、复查HE切片及免疫组织化学标记。结果 病变部位：左侧扁桃体17例，右侧扁桃体14例，双侧扁桃体5例。其中以弥漫性大B细胞淋巴瘤最多见（17／36），滤泡性淋巴瘤次之（9／36），结外边缘区B细胞淋巴瘤（2／36）、外周T细胞淋巴瘤（6／36）、鼻外NK／T细胞淋巴瘤（2／36）较少。结论 扁桃体非霍奇金淋巴瘤与其他结外淋巴瘤相同，是组织形态、免疫表型、生物学行为均不同的多种类型淋巴瘤。     

扁桃体恶性淋巴瘤的临床分析

目的探讨扁桃体恶性淋巴瘤的临床特点、诊断及治疗.方法回顾分析1995年元月～2002年12月收治的21例扁桃体恶性淋巴瘤的临床资料.结果扁桃体恶性淋巴瘤占同期恶性淋巴瘤的5.4%,占同期结外淋巴瘤的10.3%,61.9%的患者表现为咽痛,52.4%的患者表现为咽部异物感,21例患者均为非霍奇金淋巴瘤,78.6%的患者为B细胞淋巴瘤,7例接受规则放化疗的患者6例生存期均已超过3年.结论扁桃体恶性淋巴瘤是比较常见的结外淋巴瘤,临床表现缺乏特异性,误诊率高,扁桃体恶性淋巴瘤主要为非霍奇金淋巴瘤,多数来源于B细胞,患者对放化疗敏感.     

咽部及鼻部非霍奇金淋巴瘤EBV感染与分型的相关性研究

目的探讨咽部及鼻部非霍奇金淋巴瘤(NHL)EB病毒(EBV)感染与分型的相关性,为NHL的临床诊治提供参考。方法选取2015年3月-2016年3月诊治127例咽部及鼻部NHL患者NHL病变组织标本,进行免疫组化染色SP法及EBVR-1的原位杂交检测,分析结果。结果 86例为NK/T细胞淋巴瘤、31例为B细胞淋巴瘤、10例为T细胞淋巴瘤,构成比分别为67.72%、24.41%、7.87%,鼻腔及咽部NHL患者以NK/T细胞淋巴瘤为主,分别占81.58%、66.67%,扁桃体NHL患者以B细胞淋巴瘤为主,占62.50%,以上各病变部位的以NK/T细胞淋巴瘤与B细胞淋巴瘤分型之间比较差异均有统计学意义(P<0.05);NK/T细胞淋巴瘤患者85例EBVR-1阳性,B细胞淋巴瘤患者14例EBVR-1阳性,T细胞淋巴瘤患者7例EBVR-1阳性,阳性率分别为98.84%、45.16%、70.00%,不同淋巴瘤分型的EBVR-1阳性率比较差异有统计学意义(P<0.05)。结论咽部和鼻部NHL分型以NK/T细胞淋巴瘤多见,但扁桃体部位则以B细胞淋巴瘤多见,EBV感染在NK/T细胞淋巴瘤发生及发展中可能起到极为重要作用。     

22例恶性淋巴瘤临床病理分析

目的 :根据WHO(2008版)造血和淋巴肿瘤分类标准,对22例淋巴瘤临床特征、临床病理特征进行分析探讨,以提高对淋巴瘤的临床病理特征及分类的认识.方法 :收集沭阳仁慈医院2010年1月-2015年12月病理诊断为恶性淋巴瘤22例患者,复习其临床资料,观察HE切片病理组织学形态与细胞学形态,并对淋巴瘤的类型、免疫组化标记结果 进行分析与探讨,按WHO(2008版)淋巴组织肿瘤分类标准,进行病理诊断与分类分型.结果:(1)22例淋巴瘤中,非霍奇金淋巴瘤(NHL)21例(95.4%),霍奇金淋巴瘤1例(4.6%).NHL21例中B细胞淋巴瘤15例(71.4%),T和HK细胞淋巴瘤6例(28.5%).B细胞性淋巴瘤15例中,弥漫性大B细胞淋巴瘤(DLBL)11例(73.3%),套细胞淋巴瘤2例(13.3%),滤泡性淋巴瘤1例(6.6%),小B细胞性淋巴瘤1例(6.6%);T细胞和NK细胞淋巴瘤6例,其中NK/T细胞性淋巴瘤4例(66.6%),其中鼻型NK/T细胞淋巴瘤3例,鼻外型NK/T细胞淋巴瘤1例,周围T细胞淋巴瘤非特异性1例,间变性大细胞淋巴瘤ALK-1例.(2)22例HL和NHL中,男性18例,女性4例,男女比例为4.5:1,发病年龄35-81岁,平均年龄60岁,病位以颈部淋巴结多见.结论 :22例淋巴瘤中,NHL发病远多于HL,NHL中以DLBCL多见;发病多见于中老年人,男性患者多见,以颈部淋巴结为多见起病部位.     

形态学联合流式细胞术对淋巴瘤骨髓浸润的应用

目的探讨形态学检查联合流式细胞术(FCM)对淋巴瘤骨髓浸润的临床应用。方法对77例淋巴瘤患者的骨髓标本行FCM免疫表型、涂片及活检,观察骨髓受累率,并初步评价其临床价值。结果 11例霍奇金淋巴瘤(HL)切片法仅发现1例骨髓受累;66例非霍奇金淋巴瘤(NHL)中,FCM检出41例,涂片法检出8例,切片法检出19例。FCM发现的41例中,18例为早期浸润(瘤细胞5%);20例为小细胞淋巴瘤(SLL);2例为浆细胞性淋巴瘤,2例为滤泡性淋巴瘤,1例同时表达T、B细胞抗原。结论形态学联合FCM检查提高了骨髓受累的检出率,免疫表型对早期浸润和SLL有重要诊断价值。     

鼻腔NK/T细胞淋巴瘤25例病理分析

鼻腔NK/T细胞淋巴瘤是一种少见、类型特殊的结外非霍奇金淋巴瘤,临床及病理诊断有时非常困难,极易造成误诊.本文收集鼻腔NK/T细胞淋巴瘤25例,进行总结分析,旨在提高临床及病理的诊断水平,减少误诊.     

结外鼻型NK／T细胞淋巴瘤的临床及病理学特征分析

目的总结结外鼻型NK／T细胞淋巴瘤的临床病理组织学特征。方法回顾性分析21例结外鼻型NK／T细胞淋巴瘤的临床表现、病理组织学特点,采用免疫组化SP法检测结外鼻型NK／T细胞淋巴瘤免疫表型、病毒EBV等表达情况。结果镜下21例均有不同程度的毛细血管增生,18例可见明确的肿瘤细胞以血管为中心呈破坏性浸润,表现为肿瘤细胞在血管内膜下及管壁内浸润,多种炎症细胞混合浸润,1例可见鳞状上皮假瘤样增生,21例的肿瘤细胞均为T细胞分化抗原CD45RO（＋）,NK细胞相关抗原CD56（＋）,T细胞颗粒相关抗原TIA．1（＋）,EBV（＋）。结论结外鼻型NK／T细胞淋巴瘤有特征性临床、病理学改变,根据典型的临床表现、病理形态学改变、免疫表型特点及EBV原位杂交阳性可作出准确诊断。     

67例面中线非霍奇金淋巴瘤临床病理及其EBV感染关系

目的 探讨面中线非霍奇金淋巴瘤(Non-Hodgkin’s lymphma，NHL)的临床病理特点及其与EBV感染的关系。方法 应用免疫组化SP法检测多种抗体标记T淋巴细胞(CD45RO、CD56、TIA-1)和B淋巴细胞(CD20、CD45RA)，同时进行EBV原位杂交检测。结果 (1)67例病例中，男女之比为2．7：1，平均年龄43岁，发病部位多位于鼻腔；(2)按照WHO新分类法，67例中B细胞淋巴瘤有31例(47．4％)，NK／T细胞淋巴瘤有30例(46．2％)，外周T(非特殊类)细胞淋巴瘤有6例(9．1％)；(3)67例中有27例EBER1／2检测表达阳性(40．3％)，其中25例为NK／T细胞淋巴瘤，2例为外周T(非特殊类)细胞淋巴瘤，31例B细胞淋巴瘤均表达阴性。结论 面中线NHL以NK／T细胞淋巴瘤多发，EBV感染与淋巴瘤组织类型有关，与部位无关。     

胃淋巴瘤的影像学

胃淋巴瘤也称恶性淋巴瘤,是一淋巴组织恶性增生疾病,通常是全身淋巴瘤的一种局部表现,也可是胃孤立的淋巴瘤,一般分为霍奇金氏病(HD)和非霍奇金氏淋巴瘤 (NHL)两大类。 1998年世界卫生组织(WHO)基本根据欧美的淋巴瘤研究专家把鉴别形态学、免疫学和基因技术结合起来,将NHL 分为T细胞和B细胞来源,然后各自再分为前身细胞淋巴瘤     

原发于小肠的非GCB亚型弥漫大B细胞淋巴瘤一例

弥漫大B细胞淋巴瘤,非特殊型可见于任何年龄段的患者,且男性略高于女性,胃肠道是最常见的结外好发部位,肿瘤细胞表达广泛的B细胞抗原标记物,如CD20和CD79α,Ki67肿瘤增殖指数通常较高。可根据肿瘤组织中CD10、BCL-6和MUM-1抗体的免疫表型将肿瘤分为生发中心型(GCB)和非生发中心型(non-GCB)。     

Study of pathogenetic role of Epstein-Barr virus in Hungarian patients with B-cell non-Hodgkin lymphomas

INTRODUCTION: The Epstein-Barr virus is a member of herpesvirus family. It plays an important role in the etiopathogenesis of Burkitt lymphoma, other B-cell non-Hodgkin lymphomas, nasopharyngeal carcinoma, X chromosome-linked lymphoproliferative disease, Hodgkin lymphomas and a part of T-cell lymphomas. It has been suggested that association of Epstein-Barr virus with lymphomas and its pathological significance in disease varies in different geographical areas. The aim of our study was to reveal the role of Epstein-Barr virus in B-cell non-Hodgkin lymphomas diagnosed in Hungary. The authors asked: A) What is the frequency of the presence of virus genome in the biopsy specimen from B-cell non-Hodgkin patients? B) Which types of virus latency can be observed? PATIENTS AND METHODS: Genomic DNA and EBER-specific RNA of Epstein-Barr virus in paraffin-embedded specimens were detected by polymerase chain reaction and in situ hybridisation, respectively. RESULTS: Out of 36 B-cell non-Hodgkin lymphoma cases, 16 (45%) were found to be positive for Epstein-Barr virus by the above methods. Expression of latency genes, nuclear antigene-2 and latent membrane protein-1 was studied by immunohistochemical technique. The 16 virus-positive non-Hodgkin lymphoma cases showed Epstein-Barr virus latency types II. (37%) or III. (63%). CONCLUSIONS: The authors data suggest that Epstein-Barr virus may be associated with the development of B-cell non-Hodgkin lymphomas in Hungarian patients.     

Alcohol intake and the incidence of non-hodgkin lymphoid neoplasms in the cancer prevention study II nutrition cohort

Although several studies have shown a lower risk of non-Hodgkin lymphoma (NHL) in alcohol drinkers compared with nondrinkers, the dose-response relation and potential differences between former and current drinking and across beverage types and subtypes are unclear. The authors examined associations of alcohol intake with risk of NHL and NHL subtypes in the Cancer Prevention Study II Nutrition Cohort, a prospective study of US men and women aged 50-74 years. Between 1992 and 2007, there were 1,991 incident NHL cases among 143,124 participants. Multivariable-adjusted relative risks and 95% confidence intervals were computed using Cox proportional hazards regression. Compared with nondrinkers, the relative risk of NHL associated with former drinking was 0.90 (95% confidence interval (CI): 0.75, 1.10); the relative risks associated with current intakes of <1, 1-2, and >2 drinks/day were 0.93 (95% CI: 0.83, 1.03), 0.91 (95% CI: 0.78, 1.06), and 0.78 (95% CI: 0.65, 0.93), respectively. Associations did not differ by sex (P-interaction = 0.45) or beverage type (P-difference = 0.22). Alcohol intake was more strongly associated with B-cell lymphoma (P-trend = 0.005) than with T-cell lymphoma (P-trend = 0.76), and associations were similar among B-cell lymphoma subtypes. In this prospective study, current heavy alcohol intake was associated with a reduced risk of NHL. Associations did not differ by beverage type and were slightly stronger for B-cell tumors than for T-cell tumors.     

Vitamin D receptor genotypes, ultraviolet radiation exposure, and risk of non-Hodgkin lymphoma

Ultraviolet radiation (UVR) exposure may influence risk of non-Hodgkin lymphoma (NHL) through vitamin D, with antineoplastic effects mediated through the vitamin D receptor (VDR). To explore the role of vitamin D in NHL risk and the potential interaction with UVR, the authors genotyped 10 VDR polymorphisms in 2,448 NHL patients and 1,981 controls from Denmark and Sweden who were recruited in 1999-2002. Odds ratios and 95% confidence intervals were computed with logistic regression. P values were 2-sided. Most VDR variants (e.g., rs731236/TaqI, rs15444410/BsmI) were not associated with overall risk of NHL, but there was some evidence of a positive association between rs4760655 and follicular lymphoma risk (nominal P(trend) = 0.004, corrected P(trend) = 0.24). There was no support for an effect of interaction between VDR variants and UVR exposure on risk of overall NHL or B-cell lymphoma subtypes. However, there was some evidence that rs731236 altered associations between UVR and T-cell NHL risk; while increasing UVR frequency lowered T-cell NHL risk among rs731236 TT carriers, an elevated risk was observed among rs731236 CC carriers (nominal P(interaction) ≤ 0.008, corrected P(interaction) ≥ 0.12). VDR does not appear to harbor major determinants of NHL risk, except perhaps for follicular lymphoma. Possible heterogeneity in effects of UVR exposure on T-cell lymphoma risk by VDR rs731236 genotype merits further investigation.     

原发性弥漫性大细胞性肠非霍奇金淋巴瘤的临床及生存分析

目的：对28例成人原发性弥漫性大细胞性（DLCL）肠非霍奇金淋巴瘤（NHL）的临床特点、治疗及生存情况进行总结。方法：采用回顾性分析研究。结果：79％的患者接受外科手术联合化疗，50％的患者取得CR，14％为PR，36％为NR－PD，中位随访时间62月，7例（25％）患者仍存活，3例（11％）患者带瘤生存，其余18例（64％）患者死亡。结论：本回顾性了分析28例原发性DLCL肠NHL的临床特征、治疗效果和生存情况，外科手术联合化疗为最常见的治疗方式，不同治疗策略，尤其是外科手术在治疗中的作用尚需前瞻性的随机研究进一步验证。     

原发性骨淋巴瘤的临床病理初步探讨

目的探讨原发性骨淋巴瘤(PLB)的临床、X线以及病理组织学诊断和鉴别诊断.方法对30例PLB患者的临床资料、X线进行回顾性分析,并进行病理组织学和免疫组化观察.结果30例PLB患者均有患骨疼痛,临床与病理诊断符合率低;X线表现为患骨侵袭性破坏,多为溶骨性,少数为硬化性和囊性;病理组织学观察30例均为弥漫性非霍奇金淋巴瘤(NHL);免疫组化显示21例为B细胞型,9例为T细胞型.结论PLB的临床及X线检查结果易与其它骨疾病相混淆而产生误诊,必须依靠病理组织学检查,并结合免疫组化标记区分细胞类型来确诊.     

Cancer incidence of 2,4-D production workers

Despite showing no evidence of carcinogenicity in laboratory animals, the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) has been associated with non-Hodgkin lymphoma (NHL) in some human epidemiology studies, albeit inconsistently. We matched an existing cohort of 2,4-D manufacturing employees with cancer registries in three US states resulting in 244 cancers compared to 276 expected cases. The Standardized Incidence Ratio (SIR) for the 14 NHL cases was 1.36 (95% Confidence Interval (CI) 0.74-2.29). Risk estimates were higher in the upper cumulative exposure and duration subgroups, yet not statistically significant. There were no clear patterns of NHL risk with period of hire and histology subtypes. Statistically significant results were observed for prostate cancer (SIR = 0.74, 95% CI 0.57-0.94), and "other respiratory" cancers (SIR = 3.79, 95% CI 1.22-8.84; 4 of 5 cases were mesotheliomas). Overall, we observed fewer cancer cases than expected, and a non statistically significant increase in the number of NHL cases.     

COX-2与VEGF在非霍奇金淋巴瘤中的表达及临床意义

目的 探讨COX-2和VEGF在非霍奇金淋巴瘤（NHL）中的表达及临床意义.方法 采用免疫组化SP法检测COX-2和VEGF在42例NHL和20例良性淋巴结病变组织中的表达.结果 COX-2和VEGF在NHL中的阳性表达率分别为45.24%（19/42）和73.81%（31/42）.COX-2和VEGF在NHL的表达呈正相关（x2=4.63,P＜0.05）.COX-2的表达与NHL的临床分期和病理组织学类型具有相关性,Ⅲ/Ⅳ期NHL患者COX-2蛋白的表达明显高于Ⅰ/Ⅱ期患者（x2=5.43,P＜0.05）,侵袭性NHL患者COX-2蛋白的表达高于惰性组（x2=5.54,P＜0.05）,而与患者性别、年龄、全身症状、IPI无相关性.VEGF的表达与淋巴瘤侵袭性及全身症状、IPI显著相关（x2=8.98,8.89,6.43,P＜0.05）,而与患者的年龄、性别、临床分期均无相关性.结论 COX-2、VEGF可能参与NHL的发生、发展过程,COX-2可能通过上调VEGF促进NHL组织的血管新生.选择性COX-2抑制剂可望成为NHL治疗的新靶点.     

乳腺原发性弥漫性大B细胞淋巴瘤临床病理及免疫组化研究

目的探讨乳腺原发性弥漫性大B细胞淋巴瘤的免疫组化亚群分类及临床分期与预后的关系。方法收集6例乳腺原发性弥漫性大B细胞淋巴瘤的临床表现、病理学特点及免疫组化亚群分类进行了回顾性分析。结果 6例均为女性,年龄28～68岁,病变部位包括右侧乳腺4例,左侧乳腺1例,双侧乳腺1例。免疫组化分型均为非霍奇金淋巴瘤（NHL）中的弥漫性大B细胞淋巴瘤（DLBCL）,根据Hans免疫组化亚群分类,其中4例为非生发中心B细胞（非GCB）样型,2例为生发中心B细胞（GCB）样型。结论乳腺原发性恶性淋巴瘤中的弥漫性大B细胞性淋巴瘤的预后与免疫组化亚群及临床分期相关,非生发中心B细胞样型预后差,生发中心B细胞样型预后要好于非生发中心B细胞样型。临床分期越高预后越差。     

Non-Hodgkin lymphoma in patients with an HIV-infection

In the period 1985-1990, 111 patients with AIDS were treated in the University Hospital Rotterdam-Dijkzigt. In 8 out of 111 patients malignant non-Hodgkin lymphoma developed. The unusual and bizarre representation is highlighted by several clinical histories and a review of literature. HIV-related non-Hodgkin lymphoma is characterized by widespread extranodal disease, often at unusual sites, and high grade B-cell malignancy. The therapeutic outcome and survival in these cases has been disappointing. Prognosis is better for patients without a prior AIDS diagnosis, higher total CD4 cell counts, good performance score and absence of an extranodal site of disease. Treatment should be tailored to individual patients based upon a variety of prognostic features.