子宫体原发性弥漫性大B细胞淋巴瘤临床病理观察

目的探讨子宫体原发性弥漫性B细胞淋巴瘤的病理诊断与鉴别诊断要点。方法对2例子宫体原发性弥漫性B细胞淋巴瘤进行临床病理特点观察,使用LCA、CD30、CD79a、CD68、CD45RO、CD3、CD20和CEA等免疫组化染色辅助诊断,并文献复习。结果子宫体原发性弥漫性B细胞淋巴瘤临床诊断困难,镜下病理形态多样,可见子宫内膜和/或肌层内淋巴样细胞增生,免疫组化B细胞标记（＋）。结论子宫原发性弥漫性B细胞淋巴瘤少见,临床易漏诊且侵袭性较高,因此准确、完整的病理诊断对预后治疗十分重要,免疫组化有辅助诊断作用。     

Osteoblast differentiation; Hyperglycemia; Osmotic stress; Diabetes 散发性伯基特及伯基特样淋巴瘤临床病理分析

目的：探讨伯基特淋巴瘤（BL）的临床病理特征、免疫表型及鉴别诊断。方法：运用组织病理学、免疫组织化学和EBER原位杂交，对13例BL及7例伯基特样淋巴瘤（BLL）患者的肿瘤组织进行检测．并复习相关文献。结果：20例散发性病例中，病变部位在淋巴结内者，位于颈部淋巴结6例．颌下淋巴结4例，锁骨下淋巴结1例，腋下淋巴结1例；病变部位在淋巴结外者，位于回盲部3例，精索、睾丸、结肠、肌肉、前列腺各1例。光镜下可见瘤组织由单一的、弥漫浸润的中等大小圆细胞组成，其中散在分布着吞噬细胞碎片的组织细胞，呈“星空”样改变。免疫表型检测示，瘤细胞弥漫表达CD20和CD79α，部分表达CD10，〉90％的瘤细胞Ki-67阳性，而CD3、CD43、bcl-2和TdT呈阴性。EBER原位杂交发现，3例瘤细胞呈阳性。结论：散发性BL属高度恶性肿瘤，确诊依赖于病理组织学与免疫组化标记。     

原发性甲状腺淋巴瘤3例临床分析并文献复习

目的 分析3例原发性甲状腺淋巴瘤患者的临床表现及诊治经过,并对原发性甲状腺淋巴瘤的诊疗进展进行文献复习.方法 整理分析陕西省人民医院2017年至2019年收治的3例原发性甲状腺淋巴瘤患者的临床表现及诊治经过.结果 3例原发性甲状腺淋巴瘤患者临床表现均为无痛性甲状腺逐渐肿大,伴有不同程度的气道压迫症状,病理类型均为非霍奇...     

超声诊断套细胞淋巴瘤1例

患者男,30岁。超声表现:左肾下极内侧与胰腺尾部之间探及9.3cm×6.5cm等回声实性肿物,边界清晰,形态较规则,有完整包膜,与左肾、胰腺分界清楚,后方与脊柱紧邻。肿物内部可见条索状高回声分隔(图1)。彩色多普勒血流显像(colorDopplerflowimaging,CDFI):肿物周边可探及丰富环绕血     

原发性心脏淋巴瘤1例

患者女,70岁。1个月前爬山时突发气促、呼吸困难,休息后缓解。现再次发作,出现眼睑浮肿,迅速扩散至整个面部,伴活动后气促、呼吸困难,轻咳,晨起时咳嗽加重,咳少量白色黏痰,少尿,色黄。查体:脉搏104次/分,血压100/60 mmHg,面部浮肿,双颊部红肿明显,无颈静脉怒张。双肺呼吸音粗,可闻及少量湿啰音。心律不齐,各瓣膜听诊区未闻及病理性杂音。实验室检查:WBC 12.7 g/L,RBC 5.94 T/L,HGB 173 g/L,GRAN 10.1 G/L,LYM%9.1%,GRAN?.2%,尿检:pH5.0,尿液蛋白( ),白细胞( ),红细胞( );生化:PCO23.87 kPa,PO 29.46 kPa,pH 7.449,Hb 91…     

肺结核合并淋巴瘤的临床病理分析

目的 探讨肺结核合并淋巴瘤的临床病理特征和发病机理。方法 回顾分析18例已确诊的肺结核并发淋巴瘤的临床病理特征、影像学特点和治疗情况。结果 18例中均为浸润性肺结核，其中13例为陈旧性肺结核，5例为涂阳肺结核；18例中霍奇金淋巴瘤5例，非霍奇金淋巴瘤13例；肺结核在淋巴瘤之前有16例，淋巴瘤在肺结核之前有2例；无结核病和淋巴瘤同时发现的病例。淋巴瘤病人可以患肺结核，可能与淋巴瘤放化疗后导致机体免疫紊乱，从而引起结核的发生。结论 在结核病的高发地区，结核病和淋巴瘤可同时存在同一病人，及时行必要的有创检查获得组织病理标本有利于早期诊断。     

脑原发性恶性淋巴瘤免疫组化及病理形态学分析─附6例报告

总结6例脑原发性恶性淋巴瘤，分析其临床症状及光镜、电镜、免疫级化特点。结果表明颅内多发病灶及颅压增高为临床特征。组织学特点为弥漫分布，围绕血管排列。LCA、L26、UCHL1、GFAP、EMA、NSE等免疫组织化学染色及1例电镜检查证实为B细胞性，并对鉴别诊断作了讨论。     

伴皮肤侵犯的鼻NK/T淋巴瘤临床病理分析及免疫组化研究

目的　探讨伴皮肤侵犯的鼻NK T淋巴瘤病理形态学、免疫表型特征。方法　对 3例伴皮肤侵犯的鼻NK T淋巴瘤进行组织形态学观察 ,并行免疫组化检测。结果　 3例患者在确诊鼻NK T细胞淋巴瘤后数月内继发皮肤病变 ,并多在 1年内死亡。皮肤及鼻腔病变组织形态学有共同特征 ,免疫表型均符合结外鼻型NK T淋巴瘤特点 ,LCA、CD2、CD5 6和TIA 1(+) ,CD3胞质阳性 ,胞膜阴性。 3例中有 2例瘤细胞表达EBV ,瘤细胞增殖指数均 >85 %。结论　鼻NK T淋巴瘤是一种高度恶性肿瘤 ,易发生皮肤侵犯 ,预后差 ,其诊断及鉴别诊断有赖于特征性组织形态学及免疫表型特点     

彩超诊断原发性脾脏淋巴瘤1例

患者男,64岁.无意中发现左上腹肿物伴间断性疼痛2个月入院.查体:全身浅表淋巴结无肿大.于左肋缘下10 cm处可触及脾脏,轻压痛.彩超:脾脏包膜不光滑,形态不规整,表面凹凸不平,厚径58.1 mm,实质内可见弥漫性分布大小不等的不均匀中低回声结节,边界欠清,形态欠规整,部分相互融合,最大结节99.6 mm×64.7 mm×58.3 mm.CDFI:结节周边可见较丰富的彩色血流信号并进入内部,周边血流最大流速 43.2 cm/s,最小14.2 cm/s, RI 0.67.彩超诊断:脾大,脾广泛多发实性占位性病变--考虑为淋巴瘤.CT:脾脏占位性病变.     

Ultrasound evaluation of American Burkitt's lymphoma.

Burkitt's lymphoma is a childhood disease that characteristically produces large, bulky abdominal tumors. Although these are potentially curable, chemotherapy can produce rapid tumor lysis, with subsequent life-threatening metabolic abnormalities, especially in those patients with large tumors or those who have compromised renal function. Twenty-two patients with proven Burkitt's lymphoma were evaluated by ultrasound. Thirteen patients had abdominal masses. These masses tended to be large, solitary, and acoustically homogeneous. Although most of these tumors were found in the pelvis, upper abdominal and retroperitoneal tumors were also encountered. None of the patients had the typical paravertebral mantle of enlarged nodes seen in other types of lymphoma. In 11 patients with abnormal intravenous pyelograms, ultrasound successfully distinguished between renal lymphoma, hydronephrosis, and, by exclusion, metabolic renal disease. The absence of lymph node disease and the presence of bulky homogeneous extranodal tumor are characteristic ultrasound findings in Burkitt's lymphoma. By locating and quantifying tumor mass and distinguishing between renal lymphoma and hydronephrosis, ultrasound proved to be clinically useful in the management of this disease.     

硬化性上皮样纤维肉瘤1例报道并文献复习

目的探讨硬化性上皮样纤维肉瘤的临床病理特点及鉴别诊断要点。方法对1例硬化性上皮样纤维肉瘤进行临床病理分析及免疫组化研究。结果肿物位于肩背部深肌层，鱼肉样，灰白色；镜下瘤细胞形态基本一致，呈圆形、卵圆形，胞质空而透亮，似上皮细胞，间质呈现明显的玻璃样变，免疫组化，vimentin( )。结论本瘤的特征是在大量硬化性间质的背景下出现上皮样肿瘤细胞，免疫组化仅vimentin( )。     

原发性皮肤间变性大细胞淋巴瘤13例临床病理分析

目的探讨原发性皮肤间变性大细胞淋巴瘤(ALCL)的临床病理形态特征、免疫组化及预后特点。方法对13例原发性皮肤ALCL进行形态学观察,免疫组化标记及随访,并结合相关文献进行讨论。结果 13例原发性皮肤ALCL中,男女之比为1.6∶1,平均年龄47岁。临床表现为皮肤斑块、结节、肿块;组织学形态多样;免疫组化示CD30均(+),大多数CD3和/或CD43(+),部分EMA、GranB和perforin(+),ALK、CKpan、CD20、CD79a、HMB45、CD68、CD15和CD117(-)。13例均经外科手术切除局部病变,再辅助以化疗和∕或放疗;9例随访时间5～55个月,1例死亡。结论原发性皮肤ALCL是低度恶性淋巴瘤,预后相对较好。诊断依赖于组织病理学及免疫组化标记。本病应与弥漫性大B细胞性淋巴瘤、黑色素瘤、低分化腺癌等鉴别。     

Secondary light chain amyloidosis with Waldenström’s macroglobulinemia and intermodal marginal zone lymphoma: A case report

BACKGROUNDThe co-existence of Waldenström’s macroglobulinemia (WM) with internodal marginal zone lymphoma (INMZL) is rare and often associated with poor prognosis.CASE SUMMARYWe present a Chinese female patient who developed secondary light chain amyloidosis due to WM and INMZL and provides opinions on its systemic treatment. A 65-year-old woman was diagnosed with WM 6 years ago and received Bruton tyrosine kinase inhibitor monotherapy for two years. Her INMZL was confirmed due to left cervical lymphadenopathy. The patient presented with oedema in both lower limbs one year ago, and was diagnosed with secondary light chain amyloidosis. Treatment with the BC regimen (rituximab 375 mg/m² monthly for 6-8 courses, and bendamustine 90 mg/m² per day × 2, monthly for six courses) was initiated, but not tolerated due to toxic side effects. Bortezomib-based therapy was given for two months, including bortezomib, dexamethasone, and zanubrutinb. Oedema in both lower limbs was relieved and treatment efficacy was evaluated as partial remission.CONCLUSIONA detailed clinical evaluation and active identification of the aetiology are recommended to avoid missed diagnosis and misdiagnosis.     

原发性骨淋巴瘤1例报告及文献复习

目的:探讨1例原发性骨淋巴瘤(PLB)的诊断、治疗及患者预后。方法:报告1例PLB患者,并结合国内外相关文献进行分析。结果:该例患者依据病变局灶活检及免疫组化结果被确诊为"弥漫大B细胞型非霍奇金淋巴瘤"。予患者常规化疗,结合单克隆抗体治疗及自体造血干细胞移植后,14个月后达到完全缓解,随访36个月,未出现新发病灶。结论:PLB的实验室检查结果和影像学表现均无特异性,早期确诊十分困难,易误诊。目前,确诊PLB依靠病理组织形态学和免疫组化检查。早期诊断、积极治疗可改善PLB患者的预后。     

Pulmonary amyloidosis and multiple myeloma mimicking lymphoma in a patient with Sjogren’s syndrome: A case report

BACKGROUNDSjogren’s syndrome (SS), which affect salivary gland function, is an autoimmune disease. SS may involve extraglandular organs. Approximately 10 to 20 percent of SS patients have clinically significant lung disease, but presentation of pulmonary amylodosis is extremly rare. The incidence of benign monoclonal gammopathy in SS patients is high, but multiple myeloma is rare. No case involving the simultaneous occurrence of two rare diseases, pulmonary amyloidosis and multiple myeloma, in the same patient with SS has been reported so far. CASE SUMMARYA 41-year-old male patient was referred to our hematology department due to incidentally detected gastric plasmacytoma. He had been diagnosed with SS four years earlier. Multiple miliary nodules, ground glass opacity in both lung fields, and enlargement of both inguinal lymph nodes was observed on chest and abdomen computer tomography. Based on the pathological findings of lung and lymph node biopsied specimens, the patient was diagnosed with pulmonary amyloidosis and multiple myeloma. Pulmonary amyloidosis and multiple myeloma associated with SS has rarely been reported.CONCLUSIONThis is an extremely rare case of simultaneous pulmonary amyloidosis and multiple myeloma in the same patient with SS.     

原发性骨骼肌淋巴瘤1例

患者男,54岁,右髋关节疼痛3个月,右下肢活动障碍1月余入院。患者3个月前无明显诱因感到右髋关节疼痛不适,活动时加重,既往健康。体检:右髋部深压痛,右腿内收受限,右腿抬高试验及“4”字试验阳性,右下肢感觉正常,全身浅表淋巴结未扪及,B超示肝脾正常,胸部CR片未见异常,试验室检查:外周血常规及白细胞分类正常。CT平扫:右侧闭孔内、外肌、梨状肌、内收短肌、内收大肌及上孖肌弥漫性明显增大(图1),正常肌肉间羽毛样脂肪线消失,密度与正常肌肉基本一致,病变肌肉边缘模糊,与正常肌肉之间的脂肪间隙仍可见,骨盆诸骨皮质完整,未见骨破坏等异常征…     

原发性肝淋巴瘤的诊断(附7例报告)

目的 探讨原发性肝淋巴瘤(PHL)的诊断方法。方法 回顾性分析7例手术病理诊断为原发性肝淋巴瘤患者的临床特点和超声等影像学表现。结果 PHL的主要临床表现为肝区胀痛或上腹不适(4例)，肝肿大(3例)；血清乙肝二对半阳性者5例，曾患肝炎5例，其中慢性肝炎或肝硬化4例；均无发热及外周淋巴结肿大；超声声像图除1例外均表现为低回声病灶，CT表现为低密度占位，二维超声和彩色多普勒超声共误诊为良性病变1例次、血管瘤4例次，误诊率为62．5％(5／8)；CT误诊为血管瘤或炎症性病变3例次，误诊率50％(3/6)；MRI误诊为血管瘤1次，误诊率50％(1/2)。结论 原发性肝淋巴瘤临床及超声等影像学表现无特异性，确定诊断必须依靠组织学检查及免疫组织化学测定。在声像图上表现为非常见的原发性肝癌及肝血管瘤等典型声像图或图像类似肝转移性肿瘤但无原发肿瘤存在时，应注意与之鉴别。     

41例淋巴浆细胞样淋巴瘤治疗与预后分析

目的：探讨淋巴浆细胞样淋巴瘤的预后，以及治疗对该病预后的影响。方法：对４１例淋巴浆细胞样淋巴瘤患者均进行了较积极的治疗及长期随访，并经统计学处理。结果：全组中位生存期３９．４个月。导致生存期缩短的主要原因是就诊时临床分期已达Ⅲ、Ⅳ期（Ｐ＜０．０１）；具有Ｂ症状（Ｐ＜０．０５）；骨髓及结外受累（Ｐ＜０．０１）。综合治疗的无瘤生存期及１年生存率高于单纯化疗（Ｐ＜０．０５），但二者生存期无显著差别（Ｐ＞０．０５）。结论：对淋巴浆细胞样淋巴瘤不应过于积极治疗，应静观其变化，适时给予必要的干预，治疗主要目的应是改善患者的生存质量。     

Gingival enlargements: Differential diagnosis and review of literature

Gingival enlargement is one of the frequent features of gingival diseases. However due to their varied presentations, the diagnosis of these entities becomes challenging for the clinician. They can be categorized based on their etiopathogenesis, location, size, extent, etc. Based on the existing knowledge and clinical experience, a differential diagnosis can be formulated. Subsequently, after detailed investigation, clinician makes a final diagnosis or diagnosis of exclusion. A perfect diagnosis is critically important, since the management of these lesions and prevention of their recurrence is completely dependent on it. Furthermore, in some cases where gingival enlargement could be the primary sign of potentially lethal systemic diseases, a correct diagnosis of these enlargements could prove life saving for the patient or at least initiate early treatment and improve the quality of life. The purpose of this review article is to highlight significant findings of different types of gingival enlargement which would help clinician to differentiate between them. A detailed decision tree is also designed for the practitioners, which will help them arrive at a diagnosis in a systematic manner. There still could be some lesions which may present in an unusual manner and make the diagnosis challenging. By knowing the existence of common and rare presentations of gingival enlargement, one can keep a broad view when formulating a differential diagnosis of localized(isolated, discrete, regional) or generalized gingival enlargement.     

颈背部弥漫性大B细胞性淋巴瘤1例

患者男,70岁,发现右侧颈部及肩胛部无痛性包块半月余.查体:右侧颈部、肩胛部分别可触及约5 cm×6 cm、7 cm×6 cm的肿块,表面光滑,边界欠清晰,质硬,活动度差,右侧肩胛部肿块局部皮肤呈红色.超声:肿块内呈不均匀混合回声,与周围组织界限不清(图1);彩色多普勒于混合回声内见丰富的血流信号;脉冲多普勒可引出高速高阻动脉血流频谱(图2).