胸腺原发性黏膜相关淋巴组织淋巴瘤2例及文献复习

  目的  探讨胸腺原发性黏膜相关淋巴组织淋巴瘤的临床病理特征、免疫组化和基因重排特点。  方法  复习2例胸腺原发性黏膜相关淋巴组织淋巴瘤的临床资料, 通过光镜观察、免疫组化染色(EnVision, 抗体包括CD3, CD20, CD79α, CD5, Bcl-2, Bcl-6, CD10, CD23, CyclinD1, AE1/AE3)、聚合酶链式反应(polymerase chain reaction, PCR)分析其临床病理特征、免疫组化和基因重排特点。  结果  2例患者均为汉族, 男女各1例, 年龄分别为57岁和53岁, 女性患者伴干燥综合征(Sj?gren's syndrome, SS)及过敏性紫癜。术前CT、磁共振成像(magnetic resonance imaging, MRI)及术后大体检查均可见边界清楚的肿物, 内含小囊。镜下可见成片的小到中等大小弥漫淋巴细胞, 主要是中心细胞样细胞和/或单核样淋巴细胞, 偶见中心母细胞或免疫母细胞样细胞。小血管丰富, 血管周围可见较多浆细胞; 并可见多房囊肿, 囊壁被覆鳞状上皮细胞及柱状上皮细胞, 伴淋巴上皮病变, 囊壁Hassall小体增多并囊性退变, 内见粉染物; 存在反应性增生的淋巴滤泡, 周围脂肪组织内散见多处小结节。免疫组化显示CD20、CD79α和Bcl-2弥漫阳性, 囊肿上皮及赫氏小体(Hassall's corpuscle)AE1/AE3阳性, 上皮间可见CD20阳性的淋巴细胞浸润。PCR显示2例免疫球蛋白重链可变区(immunoglobulin heavy chain variable region, IgHV)基因重排阳性。2例患者均开胸行肿物及部分胸腺切除术, 术后分别随访27和6个月, 未见复发及转移。  结论  胸腺黏膜相关淋巴组织淋巴瘤少见, 具有明显特点:亚洲人多发, 伴有自身免疫性疾病, 大体及镜下可见多房囊肿, 血管周围可见明显的浆细胞分化, 缺乏凋亡抑制蛋白2-黏膜相关淋巴瘤转位基因1(API2-MALT1)融合基因等。手术切除为首选治疗, 临床结局良好。     

The possible involvement of micro-organisms other than Helicobacter pylori in the development of rectal MALT lymphoma in H. pylori-negative patients

It remains unclear whether lymphoma of the mucosa-associated lymphoid tissue (MALT) in the extragastric organs is related to Helicobacter pylori infection or not. This report describes three patients with rectal MALT lymphoma negative for H. pylori infection, all of whom showed disease regression after being treated with antibiotics. One patient had MALT lymphoma in both the descending colon and the rectum; the other two patients had rectal disease only. None of the patients had chronic gastritis which was detectable either endoscopically or histologically and H. pylori infection was completely ruled out by various methods, including a urease breath test. These patients received antibiotic therapy. In all the patients, regression of MALT lymphoma was observed endoscopically and histologically, and polymerase chain reaction revealed that a previously observed rearranged band of immunoglobulin heavy chain had also disappeared after antibiotic treatment. These cases therefore suggest involvement of micro-organisms other than H. pylori in the development of rectal MALT lymphoma.     

原发性肺黏膜相关淋巴组织淋巴瘤1例报告并文献复习原发性肺黏膜相关淋巴组织淋巴瘤1例报告并文献复习

目的：探讨原发性肺黏膜相关淋巴瘤的临床特征、诊断、鉴别诊断及治疗。方法：报告1例肺黏膜相关淋巴瘤患者的临床资料、影像学表现、实验室检查和治疗、随访情况,复习国内外相关文献5篇。结果：原发性肺黏膜相关性淋巴组织淋巴瘤是抗原长期刺激,发生免疫应答及局部炎症,从无到有产生淋巴组织、淋巴细胞免疫性增殖,从良性转化为恶性,出现异常克隆而导致黏膜相关淋巴组织淋巴瘤,属于结外非霍奇金淋巴瘤。病理免疫组化特点：若κ和λ两种轻链同时染色,为多克隆性,通常提示病变的组织为良性反应性增生;若病灶细胞的免疫球蛋白仅有一种轻链（κ或λ）染色阳性,即单克隆性,则见于原发性肺低度恶性B细胞淋巴瘤。肺黏膜相关淋巴组织淋巴瘤CD20（＋）。结论：原发性肺黏膜相关淋巴瘤大多属低度恶性,发展缓慢,早期不易浸润至远处部位,手术切除彻底,术后化疗效果好。需与肺的恶性肿瘤、淋巴细胞间质肺炎、淋巴瘤样肉芽肿、隐球菌性肺炎等相鉴别。     

胃肠道黏膜相关淋巴组织淋巴瘤BCL-10的表达

目的　探讨BCL 10蛋白在胃肠道黏膜相关淋巴组织淋巴瘤 (MALToma)中表达的意义。方法　应用CD2 0、CD79a、CD3、CD4 5RO、CD2 3、CD5、CD10单克隆抗体对 4 3例胃肠道MALToma进行检测 ,其中 2 5例为经典MALToma(MALToma LG) ,临床为惰性 ;18例为伴有少数大细胞转化的MALToma(TransformedMALToma)。用SABC免疫组化的方法检测瘤细胞BCL 10蛋白的表达。结果　在 2 5例惰性MALToma标本中 10例为BCL 10核阳性 ,1例为BCL 10核与浆同时阳性 ,3例为瘤细胞浆阳性 ,11例为阴性 ;在 18例转化的MALToma中 7例为BCL 10核阳性 ,1例为BCL 10核与浆同时阳性 ,2例为瘤细胞浆阳性 ,8例为阴性。BCL 10核阳性在胃肠道MALToma中的出现率较高 ,达 4 4 .2 %。结论　BCL 10在胃肠道MALToma中发生率较高 ,该高发生率与肿瘤的发生或演进可能有一定的相关性     

T细胞前淋巴细胞白血病转ALK阴性间变性大细胞淋巴瘤一例

目的报道1例T细胞前淋巴细胞白血病(T-PLL)转变为间变性淋巴瘤激酶(ALK)阴性的间变性大细胞淋巴瘤(ALCL,ALK-),并进行文献复习。方法采用MIC标准诊断。形态学检查包括骨髓涂片(瑞特染色法)、胸水涂片,细胞块、淋巴结活检、免疫化学染色;R显带技术进行细胞遗传学分析;多色流式细胞仪分析免疫表型。结果该患者以T-PLL起病,骨髓中异常细胞表型:CD2+、CD3+、cCD3+、CD4+、CD7+、CD8-、CD10-、HLA-DR+、cTDT-、TCRα/β+,CD38、CD5部分阳性。染色体核型:46,XX。6个月后确诊为ALCL,染色体核型:94,XXX,-X,1q-x2,+3mar。结论 T-PLL可转变为ALCL,ALK-。     

30例原发性小肠淋巴瘤病理分析

目的：研究原发性小肠淋巴瘤（PSIL）的病理特点。方法：对30例PSIL患者的组织标本行苏木精-伊红（HE）染色、免疫组化检查,其中2例行基因重排检查,并结合文献进行分析。结果：30例PSIL患者的病理诊断均为非霍奇金淋巴瘤（NHL）,其中B细胞来源23例（76.7%）、T细胞来源7例（23.3%）。其组织学类型分别为弥漫大B细胞淋巴瘤16例（53.3%）、黏膜相关淋巴组织（MALT型）B细胞淋巴瘤7例（23.3%）、外周T细胞淋巴瘤6例（20.0%）、自然杀伤（NK）/T细胞淋巴瘤1例（3.4%）。免疫组化结果示,30例PSIL均表达CD45,AE1/AE3均阴性,4例B细胞淋巴瘤EMA弱阳性。23例B细胞淋巴瘤均表达CD20和CD79α,7例T细胞淋巴瘤均表达CD3和CD45RO。NK/T细胞淋巴瘤还表达CD56和TIA-1。16例弥漫大B细胞淋巴瘤有6例（37.5%）表达Bcl-2蛋白,10例（62.5%）表达MIB-1。7例MALT型B细胞淋巴瘤中有5例（71.4%）表达Bcl-2,1例（14.3%）表达MIB-1。基因重排结果示,2例B细胞淋巴瘤均呈Fr2A、Fr3A阳性,TcR阴性。结论：PSIL大多为B细胞来源的NHL,最常见的组织学类型是弥漫大B细胞淋巴瘤。Bcl-2、MIB-1的阳性率与肿瘤病理分型相关。     

胃黏膜相关淋巴组织淋巴瘤的内镜和病理诊断

目的 探讨胃黏膜相关淋巴组织(MALT)淋巴瘤的内镜和病理特征，以减少误诊、漏诊，提高诊断正确率。方法 对1986～2003年该院经病理证实的32例胃MALtT淋巴瘤的临床、内镜和病理资料进行回顾性分析。结果 32例患者平均57.1岁，男女比例1：3，临床症状无特殊性。肿瘤多位于胃体下部和／或胃窦部．占90．6％；侵犯全层者，占44.0％；区域淋巴结转移，占32.0％。病理形态学改变肿瘤组织由中心细胞样细胞组成、淋巴上皮病变及反应性淋巴滤泡。该组病例内镜活检确诊率达15．6％，内镜病理诊断正确率达40．6％，术后病理确诊率达100％。免疫组织化学证实为B细胞淋巴瘤。结论 内镜下多块取检、深取检，结合以上病理特点和免疫组织化学，有助于诊断胃MALT淋巴瘤。     

Primary ileal plasmacytoma arising in mixed low- and high-grade B-cell lymphoma of mucosa-associated lymphoid tissue type

We report an extremely rare case of primary ileal plasmacytoma accompanied by mixed low- and high-grade B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) type. The radiographic and macroscopic features of the tumor were characterized by two constricting lesions in the ileum. Histologic examination of the resected specimen showed that one constrictive lesion was plasmacytoma and the other MALT lymphoma was low and high grade. The plasmacytoma seemed to have differentiated from the MALT lymphoma.     

肠道黏膜相关淋巴组织淋巴瘤3号染色体三体的研究

目的　检测肠道黏膜相关淋巴组织 (MALT)淋巴瘤中 3号染色体三体 (C3三体 )的发生率 ,并探讨此变异与该肿瘤发生的关系。方法　 11例诊断为肠道MALT淋巴瘤的标本 ,根据新的WHO分类标准 ,对实验成功的 8例进行分型 ,7例为经典MALT型淋巴瘤 ,临床为惰性 ;1例在MALT型淋巴瘤基础上有大细胞转化 ,临床为侵袭性。实验中选用生物素标记的染色体特异的着丝粒探针 ,采用染色体原位杂交方法 ,以 16号染色体探针作为技术参照组 ,以肠道慢性炎症作为实验对照组 ,检测肿瘤细胞中 3号染色体的拷贝数。结果　在 7例惰性淋巴瘤患者中 5例为C3三体 ,发生率为 71.4 % ,2例为C3正常 ;1例侵袭性病例为C3三体。结论　C3三体在肠道MALT淋巴瘤中发生率较高 ,该高发生率与肿瘤的发生或演进可能有一定的相关性 ,并对协助临床诊断可能具有价值。     

小肠克罗恩病与小肠MALT淋巴瘤的临床和病理分析

目的:分析小肠克罗恩病(CD)与小肠MALT淋巴瘤的临床资料,以提高两者的鉴别诊断水平.方法:回顾性分析经手术确诊的小肠CD与MALT淋巴瘤患者的临床表现、术中所见及病理结果.结果:腹痛是这两组最常见的临床表现.8例(40%)小肠CD出现肠腔狭窄,2例(10%)伴肠瘘形成;3例小肠MALT淋巴瘤为肿块型(50%);11例(55%)CD出现透壁性炎症,10例(50%)出现镜下溃疡,3例(15%)表现为非干酪样肉芽肿;B细胞性淋巴瘤5例(83.3%).结论:小肠CD以纵行溃疡为主,伴肠腔狭窄、肠瘘形成,小肠MALT淋巴瘤以肿块型为主,以B细胞性为主.     

Laterally spreading tumor-like primary rectal mucosa-associated lymphoid tissue lymphoma: A case report

BACKGROUNDColorectal mucosa-associated lymphoid tissue (MALT) lymphoma is a rare disease, and only a few cases have been reported to date. It has no specific clinical presentations and shows various endoscopic appearances. There is no uniform consensus on its treatment. With the advancement of endoscopic technology, endoscopic treatment has achieved better results in individual case reports of early-stage patients.CASE SUMMARYWe report a case of rectal MALT in a 57-year-old Chinese man with no symptoms who received endoscopy as part of a routine physical examination, which incidentally found a 25 mm × 20 mm, laterally spreading tumor (LST)-like elevated lesion in the rectum. Therefore, he was referred to our hospital for further endoscopic treatment. Complete and curable removal of the tumor was performed by endoscopic submucosal dissection. We observed enlarged and dilated branch-like vessels similar to those of gastric MALT lymphoma on magnifying endoscopy with narrow-band imaging. And immunopathological staining showed hyperplastic capillaries in the mucosa. Histopathological findings revealed diffusely hyperplastic lymphoid tissue in the lamina propria, with a visible lymphoid follicle structure surrounded by a large number of diffusely infiltrated lymphoid cells that had a relatively simple morphology and clear cytoplasm. In addition, immunohistochemical analysis suggested strongly positive expression for CD20 and Bcl-2. Gene rearrangement results showed positivity for IGH-A, IGH-C, IGK-B, and IGL. Taking all the above findings together, we arrived at a diagnosis of extranodal marginal zone B-cell lymphoma of MALT lymphoma. Positron emission tomography-computed tomography examination showed no other lesions involved. The patient will be followed by periodic endoscopic observation.CONCLUSIONIn conclusion, we report a case of rectal MALT with an LST-like appearance treated by endoscopic submucosal dissection. Further studies will be needed to explore the clinical behavior, endoscopic appearance, and treatment of rectal MALT.     

原发性胃淋巴瘤临床病理特征及预后独立危险因素分析

目的分析原发性胃淋巴瘤（PGL）组织分型及围手术期相关因素对预后的影响。 方法对中国医科大学附属第一医院胃肠肿瘤外科1988年9月至2011年7月期间收治的53例PGL患者的临床病理资料进行回顾性分析,通过Kaplan-Meier生存曲线计算累积生存率,采用Log-rank检验单因素分析和Cox模型多因素分析分析其临床特征及围手术期相关因素对预后的影响,并通过单因素分析法分析不同病理分型,其影响预后相关因素是否存在差异。 结果53例PGL患者发病年龄21~78岁（平均年龄54岁,中位年龄58岁）。本组病例组织分型：黏膜相关淋巴组织淋巴瘤（MALT）占64.2%（34/53）、弥漫性大B细胞淋巴瘤（DLBCL）22.6%（12/53）。Ann Arbor临床分期：ⅠE期22例（41.5%,22/53）、ⅡE期19例（35.8%,19/53）、ⅢE期1例（1.9%,1/53）、ⅣE期10例（18.9%,10/53）。随访资料完整的53例患者中,1、3、5年生存率分别为81.1%、47.2%、32.1%,总体中位生存期为35个月。单因素分析显示：影响预后的相关因素中性别（P=0.021）、年龄（P=0.028）、肿瘤大小（P=0.004）、手术根治度（P<0.001）、侵犯脏器（P<0.001）、病理组织分型（P=0.006）、Ann Arbor分期（P=0.029）方面差异具有统计学意义;多因素分析显示：手术根治度（OR=3.611）、病变组织分型（OR=1.729）、Ann Arbor分期（OR=1.509）是影响预后的独立因素。影响MALT预后相关因素中性别（P=0.028）、手术根治度（P<0.001）、侵犯脏器（P<0.001）以及Ann Arbor分期（P=0.003）方面差异具有统计学意义。而DLBCL预后与患者胃肠道炎性病变、溃疡等良性疾病史存在相关性（P=0.003）。 结论肿瘤根治度、侵犯脏器、原发性胃淋巴瘤的组织分型是影响原发性胃淋巴瘤预后的独立因素;患者性别、手术根治度、侵犯脏器、Ann Arbor分期与MALT的预后存在相关性;患者胃肠道疾病史与DLBCL预后存在相关性。     

Anti-CD22 Antibody Targeting of pH-responsive Micelles Enhances Small Interfering RNA Delivery and Gene Silencing in Lymphoma Cells

The application of small interfering RNA (siRNA) for cancer treatment is a promising strategy currently being explored in early phase clinical trials. However, efficient systemic delivery limits clinical implementation. We developed and tested a novel delivery system comprised of (i) an internalizing streptavidin-conjugated monoclonal antibody (mAb-SA) directed against CD22 and (ii) a biotinylated diblock copolymer containing both a positively charged siRNA condensing block and a pH-responsive block to facilitate endosome release. The modular design of the carrier facilitates the exchange of different targeting moieties and siRNAs to permit its usage in a variety of tumor types. The polymer was synthesized using the reversible addition fragmentation chain transfer (RAFT) technique and formed micelles capable of binding siRNA and mAb-SA. A hemolysis assay confirmed the predicted membrane destabilizing activity of the polymer under acidic conditions typical of the endosomal compartment. Enhanced siRNA uptake was demonstrated in DoHH2 lymphoma and transduced HeLa-R cells expressing CD22 but not in CD22 negative HeLa-R cells. Gene knockdown was significantly improved with CD22-targeted vs. nontargeted polymeric micelles. Treatment of DoHH2 cells with CD22-targeted polymeric micelles containing 15 nmol/l siRNA produced 70% reduction of gene expression. This CD22-targeted polymer carrier may be useful for siRNA delivery to lymphoma cells.     

Ileocolonic lymphomas: a series of 16 cases

BACKGROUND: Colonoscopic and clinical differences between primary ileocolonic mucosa-associated lymphoid tissue (MALT) lymphoma and mantle cell lymphoma (MCL) have not been defined. METHODS: We reviewed colonoscopic and clinical features in eight patients with primary MALT lymphoma and eight patients with MCL in the terminal ileum and/or colorectum. All cases were examined for CD5 and/or cyclin D1 expression. RESULTS: Endoscopic features of MALT lymphoma were characterized as protrusions that were covered with normal-appearing mucosa with or without ulceration. The gross appearances of MALT lymphomas were categorized as solitary (4 patients), multiple (3 patients), and multiple lymphomatous polyposis (MLP) (1 patient). The gross features of MCL at endoscopy were categorized as multiple protrusions (2 patients), and MLP (6 patients). The clinical stages of patients with MCL were more advanced than in patients with MALT lymphoma. CONCLUSIONS: Solitary or multiple protrusions at an early clinical stage is the most common presentation pattern of patients with MALT lymphoma, but an MLP appearance at an early stage is also possible. On the other hand, MLP appearance with an advanced clinical stage is the main presentation pattern in patients with MCL, although multiple protrusions with an early clinical stage is also possible. Histological and immunohistochemical investigation including that of cyclin D1 and CD5 expression is essential to make the final diagnosis.     

胃黏膜相关淋巴组织淋巴瘤幽门螺杆菌分离株与胃炎分离株的转录组比较

目的本研究对胃黏膜相关淋巴组织淋巴瘤（MALT淋巴瘤）幽门螺杆菌分离株与胃炎分离株的转录组进行比较，以阐述胃MALT淋巴瘤幽门螺杆菌分离株的转录组特征。方法对2株分离自胃MALT淋巴瘤的菌株与胃炎菌株26695的转录组进行比较。结果胃MALT淋巴瘤幽门螺杆菌分离株之间转录组非常相似，而与胃炎菌株26695之间差异较大。 对差异表达基因进行GO功能富集分析，结果显示富集基因数前5位的为催化活性、代谢进程、细胞进程、结合、单组织进程。 Pathway显著性富集分析表明差异基因的功能主要参与氨基酸和核苷酸糖代谢、卟啉和叶绿素代谢以及乙醛和二羧酸代谢。结论胃MALT淋巴瘤幽门螺杆菌相关菌株可能通过代谢调控菌体生长和侵染宿主，从而在胃MALT淋巴瘤形成过程中发挥着重要作用。     

胸腔积液细胞病理学诊断浆母细胞淋巴瘤的探讨

目的探讨以细胞病理学及免疫细胞化学方法通过胸腔积液诊断浆母细胞淋巴瘤的特点。方法对1例浆母细胞淋巴瘤胸腔积液进行常规细胞学涂片、沉渣包埋、免疫组化染色、基因重排及EBV检测,并进行文献复习。结果胸腔积液涂片中细胞丰富,由单个散在或松散聚集的细胞组成,细胞大,有一定量的胞质,核浆比明显增高;部分胞质空泡状;核大,单核、双核或多核,圆或卵圆形,部分细胞核形不整,染色质细颗粒状,可见单个或多个核仁。大细胞间可见核偏位的浆细胞样细胞,核分裂易见,可见凋亡小体和易染体巨噬细胞。免疫组化:肿瘤细胞CD38和CD138(+),棕黄色颗粒沉积在细胞膜或部分胞质;MUM-1(+);B细胞标记物CD20、CD79α和PAX-5(-),T细胞标记物CD3、CD4和UCHL(-),CD15、CD30、ALK、calretinin、TTF-1、AE1/AE3和EMA(-)。Ki-67指数为90%。颈部淋巴结活检证实为浆母细胞淋巴瘤。免疫球蛋白Ig重链(IgH)单克隆性基因重排,EBV(-)。结论经胸腔积液诊断浆母细胞淋巴瘤少见,难度高。诊断及鉴别诊断对免疫组化的依赖程度较高。     

(18)F-fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings in Mucosa-associated Lymphoid Tissue Lymphoma of the Larynx: a Case Report and Literature Review

Laryngeal mucosa-associated lymphoid tissue (MALT) lymphoma is rare, with only 25 cases reported in the literature. This report presents a case of laryngeal MALT lymphoma in a 35-year-old female with a 6-year history of progressively worsening hoarseness. MALT lymphoma was diagnosed based on biopsy and immunohistochemical analysis. The patient received two cycles of cyclophosphamide + epirubicin + vincristine + prednisone (CHOP) chemo therapy, which was ineffective. (18)F-fluoro deoxy glucose ((18)F-FDG) positron emission tomography/computed tomography (PET/CT) showed (18)F-FDG accumulation in the larynx only and identified stage IE lymphoma. CHOP chemotherapy was terminated and the patient was treated with radiotherapy. After 3 months (total radiation dose 27 Gy), (18)F-FDG PET/CT scan showed that the laryngeal lesion was in complete remission. A review of the literature on the MEDLINE(?)/PubMed(?) databases regarding laryngeal MALT lymphoma and the use of PET/CT found that radiotherapy is the firstline treatment for stage I and II MALT lymphoma.     

T(11;18)及核bcl-10蛋白在胃肠MALT淋巴瘤中的表达

为了探讨t(11；18)(q21；q21)染色体易位及核bcl-10蛋白在胃肠粘膜相关淋巴组织淋巴瘤(MALT lymphoma)中的表达，用酸性酚氯仿法从石蜡组织中提取RNA；逆转录合成cDNA后用聚合酶链反应(PCR)扩增API2-MALT1融合基因；用免疫组织化学法检测石蜡切片中bcl—10蛋白的表达。结果表明：42例MALT淋巴瘤中，t(11；18)(q21；q21)染色体易位在低度恶性MALT淋巴瘤中的表达为14％，在伴高恶转化型MALT淋巴瘤中的表达为46％，在40例弥漫大B细胞淋巴瘤(diffuse 1arge B cell lymphoma，DLBCL)对照组中没有表达；43例MALT淋巴瘤中bcl-10蛋白在低度恶性MALT淋巴瘤的核表达为61％，在伴高恶转化型MALT淋巴瘤中的核表达为69％。结论：t(11；18)易位可能与高度进展MALT淋巴瘤有一定相关性，但与DLBCL无关;bcl-10蛋白的核表达在恶性程度不同的两组MALT淋巴瘤中无显著性差异，其原因有待进一步研究。     

Sonographic appearances of mucosa-associated lymphoid tissue lymphoma of the submandibular gland confirmed with sonographically guided core needle biopsy

A 71-year-old man presented with mucosa-associated lymphoid tissue (MALT) lymphoma of the submandibular gland 52 months after initial diagnosis of MALT lymphoma of the lung. Ultrasonography showed a well-demarcated, markedly hypoechoic, heterogeneous solid mass with linear echogenic strands and hypervascularity. Ultrasound-guided core-needle biopsy demonstrated histological findings of MALT lymphoma. Sonographic features of MALT lymphoma of the submandibular gland are characteristic and ultrasound-guided core-needle biopsy may be a suitable replacement for surgical biopsy.     

子宫体原发性弥漫性大B细胞淋巴瘤临床病理观察

目的探讨子宫体原发性弥漫性B细胞淋巴瘤的病理诊断与鉴别诊断要点。方法对2例子宫体原发性弥漫性B细胞淋巴瘤进行临床病理特点观察,使用LCA、CD30、CD79a、CD68、CD45RO、CD3、CD20和CEA等免疫组化染色辅助诊断,并文献复习。结果子宫体原发性弥漫性B细胞淋巴瘤临床诊断困难,镜下病理形态多样,可见子宫内膜和/或肌层内淋巴样细胞增生,免疫组化B细胞标记（＋）。结论子宫原发性弥漫性B细胞淋巴瘤少见,临床易漏诊且侵袭性较高,因此准确、完整的病理诊断对预后治疗十分重要,免疫组化有辅助诊断作用。