CD38在滤泡性淋巴瘤和淋巴滤泡反应性增生中的鉴别诊断价值研究

目的探讨CD38对滤泡性淋巴瘤(FL)和反应性滤泡增生(RFH)的鉴别诊断价值。方法对25例RFH和42例FL病例进行形态学及免疫组化对照分析。结果 25例RFH病例均显示CD38在反应性生发中心呈典型双相表达模式:生发中心弥漫弱表达CD38,此外还有少量CD38强阳性细胞,后者主要位于明暗区交界处与明区。CD38在FL中有2种表达模式:模式1(32例)显示肿瘤性滤泡中的瘤细胞弥漫一致的弱-中等阳性,其中30例完全没有强阳性细胞,2例仅在个别滤泡有很少强阳性细胞;模式2(10例)显示肿瘤性滤泡CD38完全阴性。共同特点是无论瘤细胞是否表达CD38,肿瘤性滤泡中缺乏强阳性细胞,或仅在个别滤泡见到很少强阳性细胞。结论 CD38在FL和RFH中有截然不同的表达模式,可为二者的鉴别提供新的依据。     

十二指肠型滤泡性淋巴瘤临床病理学特征

目的 探讨十二指肠型滤泡性淋巴瘤(DFL)的临床病理学特征.方法 收集新疆维吾尔自治区人民医院2019-10-2020-11确诊的3例DFL患者的临床症状、内镜表现、实验室检查、影像学检查等临床资料,分析其镜下形态、免疫组化表型特征、治疗及随访情况.结果 3例患者中2例女性,1例男性,年龄47～79岁.病变均位于十二指...     

发生在儿童及成人的儿童型滤泡性淋巴瘤的临床病理分析

目的探讨发生在儿童及成人的儿童型滤泡性淋巴瘤的临床病例特点。方法对2例典型儿童滤泡性淋巴瘤和1例成人的儿童型滤泡性淋巴瘤进行形态学、免疫组化及克隆性分析,并随访4~18个月。结果 3例患者均为男性,发病年龄分别为9岁、14岁及51岁。病变具有儿童滤泡淋巴瘤的典型形态学及临床表现,包括形态上呈现大而扩张的滤泡,显著的满天星现象,组织学呈高级别,具有高的增殖指数,多聚酶链分析显示免疫球蛋白基因单克隆性;病变处于临床Ⅰ期,2例儿童患者经治疗后无复发,1例成人患者未治疗,随访无进展。结论儿童和成人均可发生儿童型FL,具有类似的临床病理特点,预后良好。     

滤泡性淋巴瘤转变为弥漫性大B细胞淋巴瘤1例

<正>患者女性,38岁。左颈部、双侧腹股沟淋巴结肿大1个月,超声检查最大3cm×2.5cm×2cm,最小1.5cm×1cm×0.5cm。在当地医院切除右侧腹股沟淋巴结活检,复查诊断为滤泡性淋巴瘤(滤泡型,2级)。采用COP方案化疗4个疗程后,淋巴结缩小出院。同年因左颈部、双侧腹股沟及双侧腋     

滤泡树突状细胞表达模式变化 在淋巴瘤病理鉴别诊断中的应用价值

目的 探讨滤泡树突状细胞(follicular dendritic cell,FDC)网在各种类型淋巴瘤中的形态变化模式及其在鉴别诊断中的临床应用价值。方法 采用免疫组化方法对56例各种类型的淋巴瘤进行CD21免疫组化染色,观察FDC网的形态变化模式。其中包括弥漫大B细胞淋巴瘤8例、伯基特淋巴瘤2例、小淋巴细胞性淋巴瘤6例、浆细胞瘤6例、MALT淋巴瘤3例、外周T细胞淋巴瘤6例、间变性大细胞淋巴瘤5例、NK/T细胞淋巴瘤8例、滤泡性淋巴瘤4例、套细胞淋巴瘤3例、AITL 3例、FDC肉瘤2例。结果 FDC网在各种类型淋巴瘤中的形态变化可归为4种模式:①破坏消减型:绝大部分淋巴瘤FDC网完全或部分破坏,包括弥漫大B细胞淋巴瘤、伯基特淋巴瘤、小淋巴细胞性淋巴瘤、浆细胞瘤、外周T细胞淋巴瘤、间变性大细胞淋巴瘤、NK/T细胞淋巴瘤; ②存在型:FDC网存在,甚至有数量增多,包括MALT淋巴瘤、滤泡性淋巴瘤、套细胞淋巴瘤; ③增生紊乱型:FDC网增多、变形、紊乱,如AITL; ④全表达型:FDC网在肿瘤组织中每个细胞表达,如FDC肉瘤。结论 FDC在各种类型淋巴瘤中存在不同的形态变化模式,在淋巴瘤鉴别诊断中具有重要的临床应用价值。     

滤泡性淋巴瘤中C4d抗原沉积的意义

目的探讨滤泡性淋巴瘤（follicular lymphoma，FL）中C4d抗原的沉积及其意义。方法对133份淋巴瘤标本进行C4d抗体的免疫组化染色，同时对FL进行CD35／CAd、CD21／C4d和Bcl-2／C4d抗体免疫组化双染色，观察C4d抗原沉积分布区域及阳性率。结果26例FL中有19例肿瘤组织的瘤性滤泡中出现不规则网线状C4d抗原沉积；CD35／CAd、CD21／C4d和Bcl-2／CAd双染色证实，C4d抗原沉积在瘤性滤泡的滤泡树突细胞（follicular dendritic cell，FDC）周围；C4d阳性率与FL分级无关。FL弥漫区域以及其他类型淋巴瘤的肿瘤细胞间无C4d抗原沉积。结论C4d抗原沉积在FL瘤性滤泡的FDC周围，是FL与其他类型淋巴瘤鉴别的较特异标志之一。     

滤泡性淋巴瘤的侵袭性转化及预后分析

目的:探讨滤泡性淋巴瘤(FL)侵袭性转化和预后的相关因素。方法:收集2015年8月至2021年1月本院收治的168例FL患者的临床资料,分析各指标在组织学转化(HT)及预后中的意义。结果:病理3级、Ki-67≥40%、β₂-MG>3 mg/L、LDH>245 U/L、POD24、骨髓未受侵犯与HT相关。单因素分析结果显示,FLIPI-2高危、病理3级、Ki-67指数≥40%、贫血、β₂-MG>3 mg/L、LDH>245 U/L、HT是影响PFS的不良因素;β₂-MG>3 mg/L、LDH>245 U/L、 POD24、HT是影响OS的不良因素。Cox多因素分析结果显示,β₂-MG>3 mg/L、HT是PFS的独立危险因素;HT是OS的独立危险因素。结论:FL中病理分级、Ki-67指数、β₂-MG、LDH、POD24及骨髓累及与否可预测HT风险,同时HT、β₂-MG>3 mg/L与FL预后不良有关。     

腹股沟区滤泡性淋巴瘤误诊为淋巴结炎1例

1病例报告男,73岁。因发现左侧腹股沟区包块1个月余入院。查体:左侧腹股沟区中外侧可见有一大小约15cm×5cm×4cm的条索样包块,质硬,表面光滑,活动度可,有轻微压痛,取站立位,包块未见增大。双侧下肢有轻度水肿。血沉正常。肝功生化血脂回示:尿酸521μmoL/L,TRIG2.6mmoL/L。腹部B超示:脂肪肝并肝左叶囊性占位性病变(单纯性囊肿),肝右叶低回声区,性质待定;左侧腹股沟区多发肿大淋巴结。术前诊断:左侧腹股沟区淋巴结炎,在硬膜外麻醉下行左侧腹股沟区包块切除术。术中从左侧腹股沟中点外侧8cm处开始见脂肪组织同肿大淋巴结相嵌合,钝锐性分离…     

伴有明显淋巴滤泡的非特指外周T细胞淋巴瘤

目的　探讨伴有明显淋巴滤泡增生的非特指外周T细胞淋巴瘤的形态学特点和免疫表型。方法　对 3例特殊形态的外周T细胞淋巴瘤进行形态学观察 ,免疫组化EnVision法检测CD3、CD4 5RO、CD4 3、CD2 0、CD79a、cyclinD1、bcl 2、CD4、CD8、S 10 0等抗体 ,并用PCR方法进行T细胞受体(TCR)基因重排检测。结果　 3例患者均以全身浅表淋巴结肿大为主要表现 ,初发部位为颈部和颌下 ,发病过程中出现低热及全身皮疹 ,并有肝、脾肿大。形态学的显著特点为淋巴滤泡增生 ,套区消失 ,边缘区有中等大小、胞浆透亮的瘤细胞浸润生长。免疫表型标志为T细胞淋巴瘤。基因检测有TCRγ基因阳性条带。结论　部分非特指外周T细胞淋巴瘤可伴有明显淋巴滤泡增生 ,应注意与淋巴结反应性增生、滤泡性淋巴瘤、边缘区淋巴瘤及套区淋巴瘤等鉴别     

造血干细胞移植治疗滤泡性淋巴瘤的研究进展

与单独化疗相比,大剂量放化疗后的自体造血干细胞移植（ASCT）治疗复发难治的滤泡性淋巴瘤（FL）可以提高患者的无病生存和整体生存率,但是否能提高首次缓解的FL患者的整体生存率还存在争议。异基因造血干细胞移植（allo—SCT）是治愈FL的有效方法。初步临床研究表明,降低预处理强度可以降低allo—SCT的移植相关死亡率。     

Flow cytometric findings in the floral variant of follicular lymphoma

The floral variant of follicular lymphoma (FL-F) is an unusual variant of follicular lymphoma. The malignant “follicles” have an unusual “floral” appearance due to the proliferation of surrounding and infiltrating small lymphocytes. This variant of malignant lymphoma has been supported by immunohistochemical immunophenotyping and gene-rearrangement studies; however, the flow cytometric findings have not previously been described. We report the flow cytometric findings in two cases of FL-F. The surrounding and infiltrating small lymphocytes represented mantle cells which, in one case, obscured monoclonality were CD10+, supporting a follicular center cell origin. J. Clin. Lab. Anal. 12:310–314, 1998. © 1998 Wiley-Liss, Inc.     

Diagnosis of follicular lymphoma by laparoscopy: A case report

BACKGROUND Over the past years, only few cases of follicular lymphoma diagnosed by laparoscopy have been reported in the world. Since follicular lymphoma related ascites often causes occult disease and lacks specific clinical manifestations, it is often difficult to identify the cause by routine laboratory tests and imaging methods. Diagnostic experience is not sufficient and more cases need to be accumulated for further analysis.CASE SUMMARY Ascites due to unknown reasons often causes problems for clinical diagnosis and treatment. In this paper, we report one case with ascites in whom the reason causing ascites was not identified through routine examination. Laparoscopic examination of the celiac lesions and histological examination of the lesions were performed and the final diagnosis was peritoneal follicular lymphoma.CONCLUSION Laparoscopic abdominal examination is of great significance for the definite diagnosis of ascites due to an unknown reason.     

利妥昔单抗单药或联合硼替佐米治疗滤泡性淋巴瘤的护理

通过对11例单药利妥昔单抗（美罗华）或利妥昔单抗联合硼替佐米（万珂）治疗复发难治性滤泡性淋巴瘤（FL）患者的观察．探讨两种治疗方法的护理观察要点及措施。经给药前有效的护理评估及针对可能出现不良反应（中性粒细胞及血小板减少、疲乏、周围神经病变、胃肠道反应等）进行预防性健康指导,密切监测给药进程,对症护理,药物毒性及不良反应可有效控制．且患者耐受良好。     

Abdominal mass as the first sign of follicular lymphoma B of mesentery: Case report

Primary mesenteric lymphoma is a disease of the mesenteric lymph nodes that may represent a localized process or a component of a more disseminated pattern of disease.The case refers to a woman of 78 years, that was studied by ultrasound examination after accidental finding of abdominal mass. The examination confirmed the presence of the lesion; it defined the place (peritoneum) and the features (neoplastic lesion). Computer tomography (CT) confirmed the ultrasound diagnosis and showed an additional smaller lesion. The cytology exam from the CT biopsy showed to be a follicular lymphoma B. This case confirms the ultrasound examination role in the study of peritoneal lesions and underlines how a proper diagnostic process is essential for therapy.     

一线RCHOP方案治疗不同组织学亚型滤泡性淋巴瘤3级患者的临床疗效

目的：分析一线RCHOP方案治疗的滤泡淋巴瘤（follicular lymphoma, FL）3级患者不同组织学亚型的临床特征和预后。 方法：本研究收集和分析了2009年1月至2019年12月，在本中心初诊并予一线RCHOP方案治疗的61例FL 3级患者的临床基线和生存资料，包括42例FL 3A级和19例侵袭性FL。侵袭性FL患者为2例3A级合并3B级，8例FL 3B级和9例FL 3级伴弥漫大B细胞淋巴瘤成分。 结果：FL 3A级和侵袭性FL的患者在性别、年龄、β2微球蛋白水平，乳酸脱氢酶水平、Ann Arbor分期、B组症状、骨髓受累等基线数据上无明显差异。中位随访40.2个月，3年总生存（overall survival, OS）率在FL 3A级和侵袭性FL患者中分别是97.1%和81.9%，P=0.041。3年无进展生存（progression free survival, PFS）率在两组间无明显差异，分别是 69.1%和71.1% ，P=0.546。侵袭性FL在2年后出现PFS的平台期。 结论：FL 3A级患者在OS优于侵袭性FL，但两者的PFS无显著差异，侵袭性FL在2年后出现PFS平台期。     

Listeria monocytogenes septicemia and meningoencephalitis associated with relapsed and refractory follicular lymphoma

Listeria monocytogenes is a foodborne pathogen which causes life-threatening septicemia and meningoencephalitis. Defective cell-mediated immunity is a well-known risk factor of human listeriosis. We herein present a case of 64-year-old Japanese woman with relapsed and refractory follicular lymphoma (FL). Salvage chemoimmunotherapy with cyclophosphamide, vincristine, prednisolone, and obinutuzumab was followed by obinutuzumab maintenance therapy, when a follow-up computed tomography scan revealed recurrent lymphadenopathy. One month later, the patient presented with fever and headache. L. monocytogenes was recovered from an anaerobic blood culture. Cerebrospinal fluid analysis confirmed the presence of meningoencephalitis. The invasive listeriosis was successfully treated with meropenem for three weeks. There were several predisposing factors of invasive listeriosis in our case. Cell-mediated immunity was severely impaired by prior cytotoxic chemotherapy and low-dose prednisolone. Use of a proton pump inhibitor facilitated entry of the microorganism into the host. Under these circumstances, patients with relapsed and refractory FL are susceptible to invasive listeriosis even if they avoid high-level contaminated food products. Of note, physical examination at initial presentation detected periorbital vesiculopustular eruptions with surrounding erythema. Cutaneous listeriosis is a rare but recurrent manifestation which might be occasionally overlooked. Skin eruptions should be carefully examined for early diagnosis.     

Total endoscopic thyroidectomy after open neck biopsy of the follicular lymphoma of the thyroid gland

Remote-access total endoscopic thyroidectomy (TET) is a recently established approach that can avoid producing scars in the neck. There are no clear surgical indications for TET for benign nodules or for malignant tumors at present. We report a successful TET in a 50-year-old Japanese woman with follicular lymphoma of the thyroid gland after an open neck biopsy. She had been referred to us with a neck tumor noted 2 months earlier. Because of adhesion, we performed a combined resection of the thyroid and partial right sternohyoid muscle. To the best of our knowledge, there is no other report of a TET performed after open neck surgery. Our patient's case demonstrates that (a) the cosmetic outcome of TET is clearly superior to that of conventional open neck surgery, and (b) a TET can be suitable even for reoperation if carefully selected.