RON基因在淋巴瘤的表达及与EB病毒感染相关性研究

目的 研究RON基因在不同淋巴瘤组织及其细胞株中的表达情况及与EB病毒感染的相关性. 方法 通过免疫组织化学染色法检测淋巴瘤患者以及正常和炎性淋巴组织RON的表达,计算RON阳性组织的比例及RON蛋白表达阳性标记强度特征;蛋白免疫印迹法检测淋巴瘤细胞株RON的表达情况;并且用原位杂交的方法检测EBV编码的小RNA （EBER）在伯基特淋巴瘤和霍奇金淋巴瘤组织的表达情况.结果 RON在霍奇金淋巴瘤和伯基特淋巴瘤组织中阳性率分别为55.0％ （11/20）、66.7％（8/12）,高于其在良性淋巴组织（正常淋巴组织及炎性淋巴组织）中的表达（P均＜0.05）.进一步发现霍奇金淋巴瘤和伯基特淋巴瘤组织芯片及其细胞株L428和Raji细胞株中RON表达水平远高于其他淋巴瘤.霍奇金淋巴瘤和伯基特淋巴瘤中EB病毒的阳性和RON过表达相关性密切.结论 RON在淋巴瘤中表达呈异质性,其中伯基特淋巴瘤和霍奇金淋巴瘤中高表达,而且两者的RON过表达和EB病毒感染密切相关.     

癌性抑制因子在非霍奇金淋巴瘤肝转移组织中的表达及其临床意义

目的探讨癌性抑制因子(CIP2A)在非霍奇金淋巴瘤肝转移组织中表达的临床意义。方法选取该院2005年6月至2014年9月38例非霍奇金淋巴瘤肝转移患者,应用RT-PCR法检测非霍奇金淋巴瘤肝转移、肝转移灶周边组织及正常肝组织的CIP2A含量,并分析其与肿瘤病理特征之间的关系。结果 38例患者中,非霍奇金淋巴瘤肝转移组织CIP2A表达阳性26例,阳性率68.4%,肝转移灶周边组织表达阳性9例,阳性率23.68%,正常组织未见CIP2A表达,CIP2A含量与肝转移瘤直径、乳酸脱氢酶(LDH)水平及肿瘤个数具有密切的相关性。结论 CIP2A在非霍奇金淋巴瘤肝转移组织中高表达,有特异性,与其病理特征呈相关关系,可作为非霍奇金淋巴瘤肝转移诊断与治疗的分子标志物。     

Molecular diagnosis of primary mediastinal B cell lymphoma identifies a clinically favorable subgroup of diffuse large B cell lymphoma related to Hodgkin lymphoma

Using current diagnostic criteria, primary mediastinal B cell lymphoma (PMBL) cannot be distinguished from other types of diffuse large B cell lymphoma (DLBCL) reliably. We used gene expression profiling to develop a more precise molecular diagnosis of PMBL. PMBL patients were considerably younger than other DLBCL patients, and their lymphomas frequently involved other thoracic structures but not extrathoracic sites typical of other DLBCLs. PMBL patients had a relatively favorable clinical outcome, with a 5-yr survival rate of 64% compared with 46% for other DLBCL patients. Gene expression profiling strongly supported a relationship between PMBL and Hodgkin lymphoma: over one third of the genes that were more highly expressed in PMBL than in other DLBCLs were also characteristically expressed in Hodgkin lymphoma cells. PDL2, which encodes a regulator of T cell activation, was the gene that best discriminated PMBL from other DLBCLs and was also highly expressed in Hodgkin lymphoma cells. The genomic loci for PDL2 and several neighboring genes were amplified in over half of the PMBLs and in Hodgkin lymphoma cell lines. The molecular diagnosis of PMBL should significantly aid in the development of therapies tailored to this clinically and pathogenetically distinctive subgroup of DLBCL.     

Effective treatment of advanced Hodgkin lymphoma with a modified BEACOPP regimen for a patient with demyelinating hereditary motor and sensory neuropathy type 1 (HMSN1)

Treatment for Hodgkin lymphoma (HL) in adults comprises substantial risk of chemotherapy‐induced peripheral neurotoxicity. Here, we describe the case of patient with Charcot–Marie–Tooth disease or HSMN1 and advanced Hodgkin lymphoma undergoing treatment with modified BEACOPP achieving complete remission without major aggravation of neurological symptoms.     

Association between Epstein-Barr virus and classic Hodgkin lymphoma in Jordan: a comparative study with Epstein-Barr virus-associated Hodgkin lymphoma in North America

An association between Epstein-Barr virus and Hodgkin lymphoma has been shown in several parts of the world. The reported incidence of Epstein-Barr virus in Hodgkin lymphoma varies significantly from one country to another and ranges from <30% in Swedish patients to 100% in patients from Kenya. Using in situ hybridization for detection of Epstein-Barr virus-encoded RNA and immunohistochemistry for detection of Epstein-Barr virus latent membrane protein, we analyzed 28 cases of Hodgkin lymphoma from Jordan and 30 cases from the United States. Eight of 28 Jordanian cases and 9 of 30 North American cases were Epstein-Barr virus positive. Our studies show that the incidence of Epstein-Barr virus among Jordanian patients with Hodgkin lymphoma is similar to the rate in patients from the United States. This rate appears to be low to intermediate compared with rates in other parts of the world.     

肺霍奇金淋巴瘤1例报告并文献复习

目的：探讨肺霍奇金淋巴瘤的诊断与鉴别诊断。方法：对1例肺霍奇金淋巴瘤病例进行诊断回顾并复习文献。结果：患者,女,27岁,临床表现为皮肤瘙痒,咳嗽、咳痰,左上肺大片状致密度阴影,X线是发现本病的主要手段,病理是确诊的主要依据。患者经化、放疗病情缓解。结论：肺霍奇金淋巴瘤术前临床诊断不容易,要与细支气管肺癌、肺结核、肺结节病、肺真菌感染、Wegener‘s肉芽肿和肺淋巴瘤样肉芽肿病等疾病鉴别。     

Synchronous tumors: Hodgkin disease presenting in mesenteric lymph nodes from a right hemicolectomy for colon carcinoma

The authors report the case of a 56-year-old male diagnosed with Hodgkin disease involving the mesenteric lymph nodes recovered from a right hemicolectomy for colonic adenocarcinoma. The liver and bone marrow were also involved by Hodgkin disease. Synchronous colonic carcinoma and lymphoma in the same patient is a rare occurrence, and Hodgkin disease involving the mesenteric lymph nodes is uncommon as well.     

Role of the primary care physician in Hodgkin lymphoma

Approximately 8,200 new cases of Hodgkin lymphoma are diagnosed annually in the United States. Common presenting features include painless lymphadenopathy (usually above the diaphragm), cough, fever, night sweats, and weight loss. To decrease late complications, treatment has gradually evolved toward shorter-duration chemotherapy with use of lower-dose, shorter-duration radiation therapy. ABVD (a chemotherapy regimen consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine) is now more commonly used than MOPP (a regimen consisting of mechlorethamine, vincristine, procarbazine, and prednisone) in patients with Hodgkin lymphoma. Many significant complications of therapy (e.g., cardiovascular conditions, infertility, premature menopause, secondary neoplasms) directly reflect the choice of primary treatment and may be reduced by more current treatment strategies. Recurrences of Hodgkin lymphoma are most common in the first few years after diagnosis and treatment. Prognosis is related to the stage of lymphoma, disease bulk, and age of the patient. Currently, more than 80 percent of patients with newly diagnosed Hodgkin lymphoma are expected to be long-term survivors.     

Positron emission tomographic scans in lymphoma: convention and controversy

The use of sensitive and specific imaging techniques for accurate initial staging and evaluation of response to therapy in patients with lymphoma is essential for their optimal management. Fluorine 18 fluorodeoxyglucose (FDG) positron emission tomography (PET) integrated with computed tomography (CT) has emerged as a powerful imaging tool and is being routinely used in staging, response evaluation, and posttreatment surveillance in patients with non-Hodgkin lymphoma and Hodgkin lymphoma. PET/CT is currently widely used in clinical practice, but the established clinical benefit is currently restricted to the posttreatment evaluation of Hodgkin lymphoma, diffuse large B-cell lymphoma, and follicular lymphoma. Although used in other histologic subtypes and in other clinical situations including response assessment, its impact on patient outcome remains to be demonstrated. We performed a literature search of PubMed from 1999 to 2011 using the following keywords: PET scan, FDG-PET, PET/CT, lymphoma. This review addresses the challenges and controversies in the use of PET/CT scans in the management of patients with lymphoma.     

原发扁桃体淋巴瘤的类型构成研究:213例会诊病例分析

目的探讨会诊病例中原发扁桃体淋巴瘤的病理类型、构成比率以及疑难会诊病例病种。方法收集北京友谊医院2005年1月至2013年11月213例原发扁桃体淋巴瘤的会诊病例,对其临床资料、病理组织学及免疫组织化学标记结果进行回顾性分析,按世界卫生组织(WHO,2008年版)分类标准进行病理诊断及分类,并与国内外原发扁桃体的淋巴瘤进行对比分析。结果 213例原发扁桃体淋巴瘤中,非霍奇金淋巴瘤(NHL)212例(99.5%),霍奇金淋巴瘤(HL)1例(0.5%)。NHL中B细胞来源183例(85.9%),T细胞或NK细胞来源29例(13.6%)。NHL中,检出率构成比居前5位的分别为弥漫大B细胞淋巴瘤-非特殊类型(DLBCL-NOS)138例(64.8%),滤泡性淋巴瘤(FL)12例(5.6%),黏膜相关淋巴组织边缘区B细胞淋巴瘤(MALT)12例(5.6%),结外NK/T细胞淋巴瘤11例(5.2%),外周T细胞淋巴瘤-非特殊类型(PTCL-NOS)9例(4.2%)。本组病例中HL仅1例(0.5%),为经典HL-混合细胞型。病变部位:左侧93例(43.7%),右侧96例(45.1%),双侧24例(11.2%)。结论 213例原发扁桃体淋巴瘤的会诊病例中,包括209例已明确分型和4例未能明确分型病例。已明确分型的病例共12种不同的病理类型。其中,NHL发病远多于HL,B细胞淋巴瘤中以DLBCL-NOS最多见,T细胞或NK细胞淋巴瘤中以结外NK/T细胞淋巴瘤最多见,HL罕见。     

Detection of T-regulatory cells has a potential role in the diagnosis of classical Hodgkin lymphoma

Previous studies have demonstrated an increase in T-regulatory cells in the involved lymph nodes and peripheral blood of patients with Hodgkin lymphoma. Our study examined whether the detection of T-regulatory cells by flow cytometry could distinguish classical Hodgkin lymphoma (CHL) from benign cases and B-cell non-Hodgkin lymphomas (B-NHL). We measured CD4, CD25, and CD152 in 14 CHLs, 2 nodular lymphocyte-predominant Hodgkin lymphomas, 31 B-NHLs, and 54 benign cases. All T-regulatory cell parameters, including percent lymphocytes CD4+/CD152+ and CD4+/CD25+/CD152+, and mean and median CD152 expression in CD4+/CD25+ lymphocytes, were higher in CHL than in B-NHL and benign. Mean CD152 in CD4+/CD25+ lymphocytes distinguished CHL from benign with 79% sensitivity and 100% specificity, and from B-NHL with 71% sensitivity and 90% specificity. Overall, our results show that T-regulatory cells are increased in CHL and their detection may be a useful tool in differentiating CHL from other entities.     

灰区淋巴瘤2例临床病理分析

目的:探讨灰区淋巴瘤(grey zone lymphoma,GZL)的临床和病理组织学特征。方法:应用光镜观察及免疫组化染色对2例GZL患者的病理标本进行分析,同时复习相关文献。结果:例1患者经右锁骨上淋巴结活检,其肿瘤病理组织学形态类似经典型霍奇金淋巴瘤(classic Hodgkin's lymphoma,CHL),但肿瘤细胞免疫表型为CD30+、CD15-、CD20+。例2患者为纵隔肿瘤,肿块主要表现为弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLB-CL),肿块边缘灶区分布霍奇金细胞和RS(Hodgkin's and Reed-Sternberg,HRS)样细胞,这些细胞呈CD30+、CD15+、部分CD20+、CD79α+、BOB.1+、OCT2-,同时部分HRS样细胞呈EBV+。结论:本研究的2例GZL患者在组织学形态和免疫学表型上同时具有CHL和DLBCL的共同特点,预后较差。     

造血干细胞移植治疗恶性淋巴瘤

移植技术的进步和新的抗B/T细胞单克隆抗体的出现,造血干细胞移植(HSCT)治疗恶性淋巴瘤取得了令人鼓舞的进步。本文重点介绍霍奇金病(Hodgkin disease,HD)和非霍奇金淋巴瘤(Non Hodgkin lymphoma,NHL)治疗进展。     

原发性肺淋巴瘤9例临床分析并文献复习

目的探讨原发性肺淋巴瘤的临床特征和诊断。方法回顾性分析苏州大学附属第一医院2000年1月至2011年4月诊治的9例原发性肺淋巴瘤的临床资料,对其临床表现、影像学特点、确诊手段、分期进行分析。结果霍奇金淋巴瘤1例,非霍奇金淋巴瘤8例,其中黏膜相关淋巴组织型（MALT）淋巴瘤2例,弥漫性大B细胞淋巴瘤2例,浆细胞样淋巴瘤1例,周围性T细胞淋巴瘤2例,未能进一步明确分类1例。临床以咳嗽、发热常见,2例无症状因体检发现。CT多表现为结节肿块、肺部实变,实变影中常见支气管充气征。6例行肺穿的患者仅1例明确诊断。8例经开胸肺组织活检病理检查明确。9例患者淋巴结外淋巴瘤临床分期ⅠE期7例,Ⅱ1E期1例,Ⅱ2E期1例。结论原发性肺淋巴瘤的临床表现及影像学表现无特征性,因而易误诊,手术组织活检是其主要诊断方法,预后相对较好。     

原发性小肠淋巴瘤12例病例报道并文献复习

目的：探讨原发性小肠淋巴瘤临床特点,诊断及治疗。方法：在对2003—2008年确诊的12例原发性小肠淋巴瘤临床资料的回顾分析的基础上,复习近年文献并讨论。结果：腹痛或腹部不适（100%）,腹部肿块（50%）,腹胀（41.7%）是小肠淋巴瘤的最常见的临床表现,术前11例CT发现腹部肿瘤。12例全部行手术治疗;术后病理显示：12例均为非霍奇金淋巴瘤,其中B细胞淋巴瘤9例（75%）,T细胞淋巴瘤3例。结论：原发性小肠淋巴瘤临床表现不具有特异性,肠梗阻或腹部包块是最重要的诊断线索,确诊依赖病理,治疗采用手术为主的综合措施。     

Sonographic features of liver involvement by lymphoma.

OBJECTIVE: The liver is one of the most frequent extranodal locations of non-Hodgkin lymphoma and Hodgkin disease. Nevertheless, lymphoma constitutes only 6% to 8% of focal lesions of the liver. Few studies have evaluated the sonographic patterns of lymphoma with liver involvement. The purpose of this study was to describe the sonographic features and to evaluate the accuracy of sonography for the diagnosis of lymphoma with liver infiltration. METHODS: The abdominal sonographic findings of 23 consecutive patients with histologically proven diagnosis of lymphoma with liver involvement were reviewed. RESULTS: The most prevalent sonographic features were hepatomegaly and splenomegaly. Abdominal lymphoadenopathies were identified in 34.8% of cases. Liver nodules were seen in half of patients, and the most frequent sonographic appearance was as multiple small focal lesions. Differences in sonographic patterns between high- and low-grade non-Hodgkin lymphoma were not seen. None of the patients with Hodgkin disease had liver nodules. Concordance between sonography and computed tomography for the diagnosis of focal liver lesions was observed. CONCLUSIONS: Sonography may contribute to the diagnosis of liver infiltration by lymphoma. The presence of multiple focal liver lesions associated with splenomegaly and lymphoadenopathies should make us consider the diagnosis of lymphoma with liver involvement. Nevertheless, the low specificity of these findings requires histologic confirmation of lymphomatous infiltration of the liver.     

Primary pediatric mid-brain lymphoma: Report of a rare pediatric tumor in a rare location

Primary central nervous system lymphoma (PCNSL) is a rare disease in pediatric age group. A thirteen-year-old male child presented with complaints of headache for six months, vomiting and diplopia for three days. Magnetic resonance imaging of the brain showed a single lesion of 1.7 cm × 1.6 cm × 1.6 cm in the mid brain and tectum. He underwent a gross total resection of the tumor. The histopathological evaluation revealed B cell high grade non Hodgkin lymphoma. The patient was treated with High dose methotrexate and cranio spinal radiation. The patient was alive without disease 12 mo after completion of treatment. This case highlights importance of keeping PCNSL as differential in brain stem lesions of pediatric patients also. Radiation and chemotherapy remains the most important treatment for such patients.     

Primary nodular lymphocyte‐predominant Hodgkin lymphoma of uterine cervix mimicking leiomyoma

Nodular lymphocyte‐predominant Hodgkin lymphoma (NLPHL) accounts for about 5% of all Hodgkin lymphomas and predominantly involves peripheral lymph nodes. Primary NLPHL of uterine cervix is very rare. Here, we report cervical NLPHL with CD21 expression in a 43‐year‐old woman, who presented with abnormal vaginal bleeding for 1 year.     

原发性肠道非霍奇金淋巴瘤34例临床分析

目的探讨原发性肠道非霍奇金淋巴瘤的临床特点及治疗方法。方法回顾性分析我院2000-2009年收治的34例原发性肠道非霍奇金淋巴瘤患者的临床资料。结果本组34例患者以中年男性为主,临床表现缺乏特晃性,病灶主要分布于回盲部及结肠,单发病灶常见,全部经手术切除,病理以弥漫大B细胞型为主（26例）,非生发中心来源（non-GCB）19例,占73．1％,单纯手术14例,术后化疗18例,CHOP方案为基础的化疗有效,加用利妥昔单抗进一步提高疗效,残留病变放疗2例。结论原发性肠道非霍奇金淋巴瘤表现复杂,术前诊断困难,确诊依靠病理,弥漫大B细胞型为主要病理类型,最佳治疗方案是手术联合CHOP为基础的方案化疗。     

Case series on patients with primary central nervous system lymphoma: From clinical presentations to outcomes

Primary central nervous system lymphoma (PCNSL) is a rare form of non‐Hodgkin lymphoma. In this report, we present 11 cases of PCNSL which were treated with high‐dose MTX and WBI with a localized radiation boost to the tumor bed.