恶性淋巴瘤临床病理学回顾性分析

【目的】通过对80例恶性淋巴瘤的临床病理回顾性分析及免疫表型研究,探讨其临床病理学特征及预后。【方法】应用光镜及免疫组化染色对80例恶性淋巴瘤进行临床病理学分析,免疫组化方法检测肿瘤细胞CD20、CD79a、CD3、CD68、Bcl-2、CD10、Bcl-6、MUM-1、CD138、ALK、Ki67的表达特点。【结果】男性48人,女性32人,平均年龄58.7岁。临床病变部位以颈部(33.8%)、颌下、扁桃体和咽腭(13.8%)、肠(12.3%)、胃(10%)、腹股沟等部位为多见,少数见于中枢神经系统。临床表现依部位不同而不同,首发症状以颈部无痛性包块最常见。胃肠、头面部的可发生溃疡。镜下病理学类型以非霍奇金淋巴瘤多见(77/80),尤其是弥漫大B细胞性淋巴瘤多见(38/80),该肿瘤细胞较大,空泡状,核仁明显。瘤细胞均广泛表达B细胞标记。【结论】恶性淋巴瘤中,弥漫性大B细胞淋巴瘤最常见,其诊断主要依靠细胞形态学和免疫表型;应与大细胞恶性肿瘤相鉴别。

A clinicopathological study of Malignant Lymphoma

【Objective】 By 80 cases malignant lymphoma were retrospectively analyzed and immunohistochemical features were observed.To investigate the clinicopathological characteristics and prognosis of malignant lymphoma.【Methods】 The clinical and pathologic features 80 cases of malignant lymphoma were studied by microscopy and immunohistochemistry,with review of related literature.The antibodies used in this study included CD20,CD79a,CD3,CD68,Bcl-2,CD10,Bcl-6,MUM-1,CD138,ALK and Ki-67.【Results】 The average age of all patients containing 48 males and 32 females were 58.7 years old.The predilection site was most in head and neck（33.8%）,followed by tonsil and palate（13.8%）,intestines（12.3%） and stomach（10%）.The centri-nerve site is rare compared with head and neck.The clinical symptoms was different based on different location,painless mass in neck was mostly seen.The most frequent clinical manifestation was ulceration in intestines stomach and head-face.Pathologic type was NHL many in malignant lymphoma（77/80）.Especilly diffuse large B-cell lymphoma（38/80） was more than other.The neoplastic cells were large and vesicular,with prominent nucleolus.Furthermore,neoplasm cell generally expressed the labelings of B cell.【Conclusion】 Among the malignant lymphoma,the diffuse large B-cell lymphoma（DLBCL） was mostly seen.The diagnosis of DLBCL is fundamentally depended on the cellular morphology and immunophenotype and it should be differentiated from other malignant tumors with large cells.