Granulomatous slack skin T-cell lymphoma: an important differential diagnosis with giant cell tumor of soft tissue

Granulomatous slack skin is an indolent T-cell lymphoma, considered to be a variant of mycosis fungoides. Clinically it is characterized by areas of redundant skin, wrinkled, inelastic, with variable erythema and infiltration besides a poikilodermic surface. A differential diagnosis unknown to most dermatologists is the giant cell tumor of soft tissue, which is an extremely rare low-grade sarcoma. The authors report a patient who had undergone extensive surgery because of a primary diagnosis of giant cell tumor of soft tissue, but which proved to be granulomatous slack skin after a second interventional procedure with confirmatory histopathology.     

Infectious meningitis with atypical cerebrospinal fluid cells

Cytologic evaluation of the CSF is often difficult when trying to distinguish between truly neoplastic and reactive cells. Several non-neoplastic conditions may be associated with atypical cells in the CSF, a fact the clinician has to consider to avoid inadequate aggressive theraphies. We report here three patients with infectious meningitis (due to Herpes zoster virus in two, and neuroborreliosis in one) and cytologically atypical cerebrospinal fluid lymphocytes. Further characterization showed that the pleocyrosis in these patients was of reactive origin. Cytomorphology is frequently insufficient and histochemical, immuncytochemical and cellular genome analysis techniques may help differentiate atypical reactive cells from neoplastic cells.     

非鼻咽部T细胞淋巴瘤与EB病毒的相关性

目的：探讨EB病毒（EBV）感染与非鼻咽部T细胞淋巴瘤的关系。方法：用单克隆抗体UCHL-1、L26及EB病毒编码的潜在膜蛋白-1（LMP-1），免疫组化染色确定肿瘤的免疫表型及EB病毒转化蛋白的表达。采用原位杂交方法检测EBV编码的EBERs。结果：21例非鼻咽部T细胞淋巴瘤EBERs5例阳性的（23．8％），其中给内淋巴瘤3例，肺和胃肠淋巴瘤各1例。阳性细胞约占肿瘤细胞的10％～70％。5例EBERs阳性病例中仅1例表达LMP-1，为结内淋巴瘤。结论：非鼻咽部T细胞淋巴瘤可能与EBV的感染有关，LMP-1的阳性率较EBERs低。     

原发性中枢神经系统恶性淋巴瘤27例临床病理分析

目的 :分析和探讨原发性中枢神经系统恶性淋巴瘤 (PCNSML)的临床与病理学特点。　方法 :总结经手术证实的 2 7例PCNSML患者的临床资料 ,并进行病理学及免疫组化研究 ;　结果 :患者以中年男性为多 ,临床表现无特异性 ,术前误诊率高。病理学显示 2 6例为B细胞淋巴瘤 ,绝大多数属弥漫性大B细胞淋巴瘤 ;1例为T细胞淋巴瘤。 81.3%B细胞淋巴瘤bcl 2呈阳性表达。术后行放、化疗者生存期优于单纯手术者。　结论 :PCNSML临床早期诊断困难 ,治疗方案应采取以手术加放化疗的综合治疗措施     

Chronic lymphocytic leukaemia and lymphoma in an Iranian fat-tailed sheep: a case report

A 5-year-old Iranian fat-tailed sheep was referred to the Veterinary Clinic of Shiraz University in September 2003 with a history of emaciation, fever, decreased appetite, lethargy and cough. Small cutaneous and subcutaneous nodules were palpable, especially under the ribs on both sides of the thorax. Discrete cutaneous plaques and large scabby lesions were also observed. Very large mammary gland lymph nodes were noticed on palpation. Haematological and serum biochemical values were estimated through standard haematological and biochemical techniques. In this case a normocytic–normochromic anaemia, leukocytosis and lymphocytosis were found. The concentrations of blood urea nitrogen (BUN), creatinine, cholesterol and the activities of aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT) were higher than the values reported for sheep. Necropsy findings revealed that the lymph nodes were affected in most organs. Malignant lymphoma in the kidney, heart, spleen, mammary glands, liver and bone marrow was observed. The histopathological appearance of the affected tissues varied considerably, depending upon the degree of tumour infiltration. According to the history, clinical signs, laboratory findings, necropsy findings and histopathological examination the case was diagnosed as chronic lymphocytic leukaemia and lymphoma.     

弥漫性大B细胞淋巴瘤的病理、免疫组化特征及IgH基因重排的检测

目的 探讨弥漫性大B细胞淋巴瘤(DLBCL)临床和病理组织学特征以及免疫组化特异性抗体及IgH基因重排检测在其诊断和鉴别诊断中的价值。方法 收集30例弥漫性大B细胞淋巴瘤及其临床资料，用免疫组化孓P法标记LCA，CD20，CD79a，CD30及bcl-2抗体和用PCR方法检测15例IgH基因重排。结果 70％(21／30)弥漫性大B细胞淋巴瘤发病年龄在40～70岁，淋巴结内外都可累及。组织病理学：中心母细胞淋巴瘤占83．3％(25／30)，免疫母细胞淋巴瘤占3．3％(1／30)，间变性大细胞淋巴瘤占6．7％(2／30)，及富于T细胞B细胞淋巴瘤占6．7％(2／30)。免疫标记LCA均表现阳性，CD20、CD79a、CD30、bcl-2表达率分别为86．7％(26／30)，93．3％(28／30)，6．7％(2／30)，20％(6／30)。15例DLBCL中IgH基因重排阳性为66．7％(10／15)。结论 弥漫性大B细胞淋巴瘤是一组异质性肿瘤，必须结合其组织病理学形态和特异抗体的免疫组化检测，对一些疑难病例需做IgH基因重排检测以进行诊断和鉴别诊断。     

非霍奇金淋巴瘤85例临床及预后分析

目的：分析多种因素对非霍奇金淋巴瘤(NHL)预后的影响。方法：通过SABC法进行免疫分型，采用Kaplan—Meier法分析患者治疗后的生存期，采用Cox比例风险模型分析影响预后的因素。结果：B细胞来源-NHL(B-NHL)发病率为63．3％。T细胞来源-NHL(T—NHL)为36．7％；低度恶性占17．6％，中、高度恶性占74．1％。1、2、3、5年生存率：低度恶性患者为92．1％、84．5％、65．1％、45．1％；中、高度恶性患者为84．9％、67．5％、47．6％、28．4％。I、Ⅱ期患者为98．8％、91.5％、87．5％、70．3％；Ⅲ期、Ⅳ期患者为62．1％、55．5％、40．1％、23．8％。T—NHL为70．8％、53．5％、47．7％、30．2％；B-NHL为82．1％、70．5％、61．1％、50．1％。结论：年龄、乳酸脱氢酶水平、恶性程度、临床分期、免疫分型、身体状况评分(PS)是影响NHL预后的重要因素。     

18F-FDG PET显像在发热待查患者中筛查淋巴瘤的价值

目的　探讨18F 脱氧葡萄糖 (FDG)PET显像在长期发热患者中筛查淋巴瘤的价值。方法　对 5 9例长期发热患者 (发热持续时间至少 3周 ,测 3次体温超过 38 3℃ )的18F FDGPET显像资料进行回顾性分析 ,将18F FDGPET显像诊断结果与病理检查及随访结果进行比较。结果　 5 9例长期发热患者中有 8例PET显像示恶性淋巴瘤可能 ,最后均经病理检查确诊为淋巴瘤 ,其中 2例为霍奇金淋巴瘤 ,6例为非霍奇金淋巴瘤。结论　PET显像示长期发热的淋巴瘤患者其病变淋巴结可在正常范围内 (<1 0cm或在体内较深部位 )。对长期发热患者 ,18F FDGPET显像可初步筛查淋巴瘤及排除其他肿瘤 ,可为穿刺活组织检查提供定位信息。     

人原发性结肠恶性淋巴瘤裸小鼠原位移植肝转移模型的建立

目的 为探讨结肠恶性淋巴瘤的发病机制和实验治疗提供理想的动物模型。方法将结肠恶性淋巴瘤术中原发灶和肝转移灶新鲜瘤组织块植入裸小鼠结肠黏膜层内，观察原位移植的成瘤率，移植瘤的侵袭和转移率。进行形态学（光镜、电镜、免疫组织化学）、染色体核型和流式细胞分析。结果人结肠淋巴瘤原发灶和肝转移灶新鲜瘤组织均获得移植成功。依据WHO新的分类标准，建成1株人结肠原发性（原发灶）非霍奇金B细胞性恶性淋巴瘤裸鼠原位移植高转移模型（HCBL-0303）和1株人结肠原发性（肝转移灶）非霍奇金B细胞性恶性淋巴瘤裸鼠原位移植肝转移模型（HCBL-0304）。移植瘤组织病理学为（非霍奇金B细胞性）高度恶性淋巴瘤；免疫组化显示CDl9、CD20、CD22阳性，CD3、CD7阴性。染色体数目55—59条；流式细胞DI值1．59—1．71，均为异倍体。HCBL-0303肝转移率为63．7％，淋巴结转移率为56．4％；HCBL-0304肝转移率和淋巴结转移率为100％。移植瘤在裸鼠结肠内自主侵袭性生长，发生血液转移、淋巴转移和腹腔内种植性转移。结论HCBL-0303和HCBL-0304是首次成功建立的人结肠恶性淋巴瘤裸鼠原位移植自发性肝转移模型，可用于结肠恶性淋巴瘤的发病机制、侵袭、转移及实验治疗的研究。