原发性中枢神经系统弥漫大B细胞性淋巴瘤16例临床病理分析

目的 探讨原发性中枢神经系统弥漫大B细胞淋巴瘤(diffuse large B-cell lymphomas,DLBCL)的临床病理特点和免疫分子亚型及与预后的相关性.方法 回顾性分析16例原发性中枢神经系统DLBCL的临床表现、影像特点,采用HE染色及EliVision法观察其病理组织学特点和免疫表型特征.结果 临床上主要表现为颅内压增高、肢体乏力、视力障碍和神经精神症状,可为单发或多发性病灶;影像学上,CT示肿块多呈稍低密度阴影,MRI示T1WI呈低或等信号,T2WI呈高或等信号,强化明显,病灶周围常见明显水肿带.组织学特点为瘤细胞细胞形态较单一,弥漫浸润,瘤细胞常围绕血管形成袖套状,伴片状坏死及出血.免疫分子分型示9例DLBCL为生发中心型,7例为非生发中心型.结论 原发性中枢神经系统DLBCL是高度侵袭性淋巴瘤,为2008年WHO淋巴造血系统肿瘤分类已新增加的DLBCL亚型,具有较独特的临床病理学特点及生物学行为.好发中老年人,临床表现和影像学缺乏特异性.病理组织形态特点为瘤细胞弥漫或结节分布,以瘤细胞常围绕血管袖套状浸润为其特征性结构,可有坏死、出血;分子亚型主要为生发中心型.

DLBCL of primary central nervous system: a clinicopathological analysis of 16 cases

Purpose To explore the clinicopathological features and the relationship between immunophenotype and prognosis of DLBCL of primary central nervous system(CNS).Methods The clinical and imaging features of 16 primary CNS DLBCL patients were analyzed retrospectively and followed-up.All samples were stained by HE and immunohistochemistry.Results The main clinical manifestations of CNS DLBCL included intracranial hypertension,weakness,visual disturbances and neuropsychic symptoms.It presented either as an isolat...