维吾尔族鼻淋巴瘤25例临床病理分析

目的 探讨鼻淋巴瘤在新疆维吾尔族人群中的临床及病理特点。方法 应用组织病理学、免疫组化、原位杂交技术观察25例鼻淋巴瘤的临床及病理形态学特征。结果 本组25例中NK／T细胞淋巴瘤17例，非特殊性外周T细胞性淋巴瘤4例，B细胞性淋巴瘤4例。其中17例有EBV感染。结论 新疆维吾尔族人鼻淋巴瘤以NK／T细胞型为主，大多数有EBV感染。     

肺淋巴瘤样肉芽肿1例

病例男，４２岁，因不规则发热、咳嗽、咳痰、气短伴胸痛９个月，X线示双肺结节状阴影进行性增大，疑“肺部恶性肿瘤”，于１９９７年３月收住院。外院曾诊断肺炎、肺结核，治疗无效。入院后查体T３８℃，P１０４次?分，R２５次?分，BP１５?１１．５kPa，一般情况尚可，神清、表浅淋巴结未触及、双下肺呼吸音粗糙，可闻湿罗音，心、腹部无异常，免疫学检查无异常，肺包虫试验阴性。X线检查：右肺中下野可见多个球形病灶，最大约４cm×４．５cm，病灶部分边界清晰，密度均匀，无空洞及钙化，部分病灶融合。左下肺见斑片影（图１，２）。C…     

宫颈淋巴瘤样病变8例临床病理分析

目的:探讨子宫颈淋巴瘤样病变的临床病理特征及鉴别诊断要点。方法:收集8例子宫颈淋巴瘤样病变,采用光镜、免疫组化等技术,观察其临床病理特点,并进行随访。结果:8例平均年龄42岁,临床表现6例为接触性出血,1例为白带中夹血丝,1例为体检发现宫颈息肉。妇检见宫颈糜烂5例,宫颈糜烂伴息肉3例。光镜示致密的大淋巴细胞与多量成熟的小淋巴细胞、浆细胞以及中性白细胞混合存在,大淋巴细胞的核分裂象活跃(包括病理性核分裂象)。免疫组化染色显示:大淋巴细胞及小部分成熟小淋巴细胞CD20( ),大部分小淋巴细胞CD3( ),CD30散在或灶性大淋巴细胞( ),κ、λ均阳性,且阳性细胞数量无明显差异。其中获随访资料的5例患者均健在。结论:子宫颈淋巴瘤样病变是一种反应性淋巴组织增生性病变,因其常有活跃的核分裂象而需要注意与恶性淋巴瘤鉴别,临床常表现为宫颈糜烂或糜烂伴息肉样新生物,病变特有的组织学表现及免疫组化染色有助于鉴别诊断。     

EB病毒相关性肺淋巴瘤样肉芽肿累及鼻咽部1例

患者女,68岁,体检胸部CT发现双肺多发大小不等结节、左肺上叶团块影(图1A)4个月,纵隔及肺门无肿大淋巴结,无胸腔积液,为进一步诊治入院.MRI:鼻咽部肿块侵入左咽旁间隙(图1B),增强后明显不均匀强化,颈部未见肿大淋巴结.PET/CT:鼻咽部及左肺上叶肿块代谢增高,双肺多发结节;影像学疑诊肺癌并双肺多发转移瘤、鼻咽...     

肺淋巴瘤样肉芽肿病误诊1例分析

对肺淋巴瘤样肉芽肿病误诊1例分析如下。1病历摘要男,25岁。以发热、咳嗽10个月,左胸部、颈部疼痛月余于2008-12-27入住永城市人民医院呼吸科。     

牛痘样水疱病样皮肤淋巴瘤临床病理观察

目的 总结1例牛痘样水疱病样皮肤淋巴瘤的临床特点和组织病理学特征,旨在提高对这一疾病的认识.方法 收集患者的临床资料,观察其组织学形态并行免疫组化和EB病毒原位杂交检测.结果 患儿女性,7岁.2年内面部、四肢及躯干部反复出现红斑、水疱,疱破后结痂,遗留痘疮样瘢痕,伴长期间断发热.皮肤活检:表皮内见多房水疱,水疱内、真皮层及皮下脂肪组织可见中等大小异型淋巴细胞弥漫浸润,部分围绕皮肤附属器及血管呈小叶状分布,伴血管中心性浸润和坏死.肿瘤细胞间穿插分布少量嗜酸性粒细胞和组织细胞.免疫组化肿瘤细胞CD3、CD45 RO、CD8、TIA-1、穿孔素、粒酶B和LMP-1(+),而CD56(-);原位杂交EBER(+).结论 牛痘样水疱病样皮肤淋巴瘤是好发于儿童的罕见皮肤淋巴瘤,诊断及鉴别诊断需结合临床皮疹特点、组织病理学形态、免疫组化及原位杂交综合分析.     

亲毛囊性蕈样肉芽肿的临床病理分析

目的 探讨亲毛囊性蕈样肉芽肿(FMF)的临床及病理特征.方法 对2例早期FMF患者的临床及病理特征、免疫表型、基因重排及鉴别诊断等进行分析,并结合文献进行讨论.结果 2例FMF患者均为男性,平均确诊年龄为55岁.临床表现为皮肤红斑或斑块伴脱屑及瘙痒.病理表现为真皮浅、深层血管周围、胶原间、毛囊上皮及周围异形淋巴细胞及嗜...     

肺淋巴瘤样肉芽肿病一例误诊

1　病例资料女,5 9岁。因间断发热、咳嗽2年,气促2个月就诊。2年前无明显诱因出现发热,体温最高达39 7℃,时好时坏,并呈阵发性呛咳,咳白色粘痰,近2个月活动后气促明显。曾先后按大叶性肺炎、肺结核予相应治疗无效。查体:双肺叩诊清音,右中下肺呼吸音粗,可闻少许湿音,全身浅表淋巴结不大。X线胸片检查示右中下肺及左上肺见大片状阴影,边缘模糊,余肺纹理呈网织状改变,双侧膈面及肋膈角可见,心缘模糊。肺CT检查示双肺见多发片状病灶,其内见支气管充气征,右中叶及左上叶轻度含气不全,纵隔肺门淋巴结未见明显增大。支气管镜检查未见异常。因…     

淋巴瘤样肉芽肿病的研究进展

淋巴瘤样肉芽肿病(LYG)是一种罕见的Epstein-Barr病毒(EBV,人类疱疹病毒4)相关的淋巴组织增生性疾病,通常表现为肺部多发结节性病变,胃肠道、皮肤、中枢神经系统也可受到影响,其他器官系统受累极为罕见,诊断难度大,病程不可预测,目前尚未建立LYG的标准化治疗方案。本文分析和总结了淋巴瘤样肉芽肿病的临床病理学特征、影像学特征以及近年来的新进展,希望能够对淋巴瘤样肉芽肿病的诊断有所帮助。     

肺坏死性结节病样肉芽肿病临床病理分析

目的探讨肺坏死性结节病样肉芽肿病的临床病理学特征及其鉴别诊断。方法对2例发生在肺内的坏死性结节病样肉芽肿病进行光镜观察、PAS特殊染色和免疫组化标记。结果2例患者均为无明显诱因下胸痛,胸部X线平片及CT显示肺部多个结节状阴影,胸膜增厚。镜检肺组织内形成上皮样肉芽肿,肉芽肿中央有非干酪样凝固性坏死,多核巨细胞、淋巴浆细胞浸润,小血管炎,周围纤维组织增生。抗酸杆菌染色、PAS染色(-),肺肉芽肿区域组织内CD8( ),T淋巴细胞增多。经类固醇药物治疗后2例患者临床症状均好转。结论坏死性结节病样肉芽肿病是一种较少见的多发于肺内的良性肉芽肿性疾病,病理诊断应侧重于与结节病、Wegener肉芽肿以及结核、霉菌感染等引起的肉芽肿性疾病相鉴别。     

Clinical implications of the histopathologic diagnosis of pulmonary lymphomatoid granulomatosis

We reviewed the epidemiologic, laboratory, roentgenographic, pulmonary function, and survival data from 28 patients who had a histologic diagnosis of lymphomatoid granulomatosis (LG) with involvement of the lungs. The mean age at the time of diagnosis was 51 years, and the male-to-female ratio was 3:2. Ten patients had other underlying diseases before LG was diagnosed. The most prominent symptoms were cough, dyspnea, fever, and rash, which were usually present for several months before diagnosis of LG. Multiple nodules were detected on a chest roentgenogram in 68% of the patients. Immunoglobulin concentrations were abnormal in 8 of 12 patients studied. Although bronchoscopy established the diagnosis in approximately a third of the patients who underwent this procedure, open-lung biopsy was uniformly diagnostic. The median survival was 72 months, with follow-up through 12 years. In 11 patients, the original diagnosis of LG was eventually changed to lymphoma. In five of these patients, the change in diagnosis was based on immunohistologic data obtained shortly after LG was discovered. Lymphoma diagnosed in this way was associated with a better prognosis than lymphoma diagnosed on the basis of conventional histopathologic findings. In three patients, solid tumors eventually developed. The diversity of clinical outcomes and frequent revisions of the diagnosis led us to consider the possibility that LG may also represent a histopathologic finding that occurs transiently in several disease processes.     

Pulmonary lymphomatoid granulomatosis in a 4-year-old girl: A case report

BACKGROUNDPulmonary lymphomatoid granulomatosis (PLG) is a lymphoproliferative disease associated with Epstein-Barr viral infection occurring mainly in adults and rarely in children. It is characterized by multiple pulmonary nodules. Its diagnosis depends on lung biopsy findings. Most patients are immunodeficient, and it commonly presents in children undergoing chemotherapy for leukemia. We report the case of a child with PLG caused by a mutation in the macrophage-expressed gene 1 (MPEG1), suggesting possible PLG occurrence in children undergoing treatment for pulmonary nodular lesions.CASE SUMMARYThis study reports a case of PLG without apparent immunodeficiency, suggesting the possibility of this disease occurrence during the treatment of pulmonary nodular lesions in children. Initially, the cause was assumed to be an atypical pathogen. Following conventional anti-infective treatment, chest computed tomography findings revealed that there were still multiple nodules in the lungs. Additionally, the patient was found to be infected with the Epstein-Barr virus. Histopathological examination of the resected lung revealed lymphoproliferative lesions with necrosis. Small lymphocytes, plasma cells, and histiocytes were observed in the background, although Reed-Sternberg cells were absent. Immunohistochemical staining [CD20(+), CD30(+), and CD3(+)] and EBV-encoded small RNA1/2 in situ hybridization of small lymphocytes revealed approximately 200 cells/high-power field. Whole exon sequencing of the patient revealed a mutation in the MPEG1. The patient was eventually diagnosed with PLG and transferred to the Department of Pediatric Oncology for bone marrow transplantation.CONCLUSIONAs PLG is rare and fatal, it should be suspected in clinical settings when treatment of initial diagnosis is ineffective.     

类固醇激素反应性慢性淋巴细胞性炎症伴脑桥血管周围强化症演变为淋巴瘤样肉芽肿1例临床病理观察

目的 探讨类固醇激素治疗后反应性慢性淋巴细胞性炎伴脑桥血管周围强化症(CLIPPERS)发展为淋巴瘤样肉芽肿的发病机制、临床表现及病理学特征.方法 结合临床、影像、组织学特点及预后对解放军总医院第一医学中心病理科1例患者资料进行回顾性分析.结果 本文1例患者,女性、52岁,主因出现头晕、行走不稳,口角左歪10天入院;随...     

韦格纳肉芽肿病肺部损害的CT分析

目的探讨韦格纳肉芽肿WG肺部CT表现,提高对该病的诊断水平。方法总结分析经病理和临床证实的WG11例的肺部表现,其中胸片11例,胸部CT平扫加增强扫描8例。结果 11例中,肺部有异常表现10例。异常表现中片状浸润病灶3例,多发结节影(直径小于3cm)4例,肿块(直径大于3cm)3例,空洞8例,条状阴影1例。4例多种病灶混合存在。结论 WG肺部表现呈多样性,以片状浸润、结节和空洞病变最常见,薄壁空洞和环形空洞具特征性。此病要与肺炎、肺脓肿、肺结核和肺癌等疾病相鉴别。     

心脏血管瘤临床病理特征分析

目的 探讨原发心脏血管瘤的临床特征及病理形态特征。方法 回顾性收集2015年至2021年原发心脏血管瘤存档切片，整理相关病史资料、治疗经过，复习组织病理形态，并进行随访。结果 共获得23例原发心脏血管瘤病例资料。男性11例，女性12例。年龄17～71岁。单发病灶22例，多发病灶1例。来源于心腔内10例，心脏表面13例。肿瘤最大径为1.0～11.3 cm。组织形态上，海绵状成分为主的血管瘤18例，毛细血管瘤成分为主的4例，另有一些少见细胞形态和生长模式。病灶均完整手术切除，随访时间8～88个月，患者均存活、无复发。结论 心脏血管瘤以单发为主，起病隐匿，常伴有心包积液，预后较好。组织学以海绵状形态为主，可出现少见细胞形态，有潜在误诊的风险。     

脑实质内神经鞘瘤临床病理分析

目的探讨脑实质内神经鞘瘤的临床病理特征、免疫组化表型和鉴别诊断。方法报道1例罕见的脑实质内神经鞘瘤,并结合文献对其临床资料、病理特征、免疫组化表型及治疗和预后等进行分析。结果患者年龄44岁,肿瘤为单发,境界清楚。镜下肿瘤细胞呈梭形,形态温和,细胞排列呈栅栏状,可见典型Antoni A区和Antoni B区,未见核分裂象。免疫组化结果:S-100(+++),Vimentin(+),GFAP(灶+),Nestin(灶+),CK(-),EMA(-),Syn(-),NF(-),CD34(-),BCL-2(-),CD99(-),Neu N(-),Ki-67(2%+)。结论脑实质内神经鞘瘤发病罕见,较易误诊为转移瘤,诊断主要依靠组织形态学特征,影像学表现、免疫组化有助于和其他肿瘤鉴别诊断。手术完整切除可治愈。患者随访两年预后良好。     

乳头状膀胱炎的临床病理分析

本文回顾性分析6例乳头状膀胱炎的临床表现、形态学改变。在6例患者中,男2例,女4例,年龄44~73(57.3±10.19)岁,膀胱三角区5例,膀胱侧壁1例,肿物直径0.4~1.5 cm。病变有炎症背景,宽广的基底,指状、乳头状突起,间质纤维化或水肿,被覆上皮无异型性。乳头状膀胱炎是一种少见的膀胱炎症类型,易被误诊为低级别尿路上皮肿瘤,组织学改变有特征性。