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目的探讨口腔颌面部弥漫大B细胞淋巴瘤(DLBCL)的临床病理学特点及其预后相关因素。方法对69例口腔颌面部DLBCL进行回顾性临床病理分析,包括形态学复习、免疫表型和EB病毒编码小RNA(EBV—EBER)原位杂交检测,结合临床随访结果进行预后相关因素分析,并与同期诊断的40例原发淋巴结DLBCL进行比较。结果69例口腔颌面部DLBCL患者中位发病年龄61岁(4—91岁),男女比例为1.56:1。发病部位以舌根最为常见(19例,27.5%),其次为腮腺、齿龈、腭等。肿瘤细胞多起源于非生发中心B细胞,比例为64.2%(43/67),bcl-2、c—myc及EBV—EBER阳性率分别为66.7%(38/57)、23.4%(11/47)及5.3%(3/57),Ki-67高表达(t〉70%)者占71.0%(49/69)。42例获得完整随访资料,生存时间1—85个月,生存分析显示年龄I〉65岁、Ki-67高表达者预后差,R-CHOP方案治疗组预后好于CHOP方案及放疗组。与同期诊断为原发淋巴结DLBCL相比,除了肿瘤细胞的起源分组有明显差异外,其余临床病理特点及预后差异均无统计学意义(均P〉0.05)。结论口腔颌面部DLBCL最常见于舌根,多为非生发中心B细胞起源,临床病理特点及预后与淋巴结DLBCL相似。年龄≥65岁和Ki.67高表达是独立的预后不良提示因素。R—CHOP方案治疗组预后好于CHOP方案治疗组。 相似文献
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目的 探讨老年人EB病毒阳性(EBV+)弥漫大B细胞淋巴瘤(DLBCL)的临床病理学特点及预后.方法 采用回顾性研究的方法 ,收集24例老年EBV+DLBCL患者,以同期EBV-非特指型DLBCL患者为对照,分析老年EBV+ DLBCL患者的临床病理学特点及预后.结果 24例老年EBV+DLBCL患者肿瘤细胞形态上主要表现为单一性或多形性肿瘤细胞增生;多形性病例中常可见有地图状坏死.细胞起源免疫分型主要为非生发中心亚型,分别占91.3%(Hans分型)和100.0%(Choi分型).CD30阳性率为55.0%,高于非特指型EBV-DLBCL(P< 0.001).在总体生存时间方面,R-CHOP方案治疗的老年EBV+DLBCL患者和>50岁EBV-DLBCL患者的中位生存时间分别为44.2个月和29.2个月,两者差异无统计学意义(P=0.587).结论 老年人EBV+DLBCL肿瘤细胞形态上主要表现为单一性或多形性肿瘤性增生;多形性病例中常可见不规则坏死.CD30阳性率较高,并且主要为非生发中心B细胞亚型.R-CHOP方案治疗的老年EBV+ DLBCL患者的总体生存时间与同年龄段非特指型EBV-DLBCL患者相近. 相似文献
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目的 探讨治疗相关标志物PD-L1、PD-L2、CD30、CD23、BCL-2、BCL-6、MUM1和GATA3在原发纵隔大B细胞淋巴瘤(PMBL)诊断和预后评估中的应用价值。方法 收集PMBL的34例患者进行回顾性研究,31例非纵隔原发的非特指型弥漫性大B细胞淋巴瘤(DLBCL-NOS)作为对照组,免疫组织化学染色方法检测8种蛋白的表达情况。结果 PD-L1、PD-L2和CD30在PMBL组阳性肿瘤细胞百分比的中位数分别为70%(30%, 90%)、25%(0, 70%)和17.5%(0, 60%),显著高于DLBCL-NOS组,差异有统计学意义(P<0.05);CD30和CD23在PMBL组的阳性率分别为61.76%(21/34)和76.47%(26/34),与DLBCL-NOS组之间差异有统计学意义(P=0.000)。伴有CD30或BCL-6表达的PMBL患者生存曲线尽管P>0.05,仍显示出预后差的趋势。结论 PMBL中PD-L1、PD-L2和CD30的表达水平较高,有助于精准识别更多可能对免疫或靶向治疗有反应的患者。免疫组织化学标记PD-L1、PD-L2、CD30和CD23有助于PMBL与DLBCL-NOS鉴别诊断。CD30和BCL-6作为PMBL的候选预后指标应该在更大量的样本中进一步研究。 相似文献
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【摘要】 新的WHO分类将原发纵隔B细胞淋巴瘤(PMBCL)归为弥漫大B细胞淋巴瘤(DLBCL)的一个独立亚型,其在发病机制、病理组织学、分子遗传学及临床特点等多个方面均与其他类型的DLBCL有所不同,与霍奇金淋巴瘤及纵隔灰区淋巴瘤又有着密切地联系,为加深临床医师对PMBCL的认识,就近年来的相关研究进行综述。 相似文献
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目的 探讨弥漫性大 B细胞淋巴瘤(DLBCL)的临床病理特征、免疫表型,以提高对DLBCL的诊断水平。方法 对22例DLBCL患者进行回顾性分析,复习组织形态和临床表现,补充完善所有患者CD20、CD3、CD10、bcl-6、MUM-1、Ki-67免疫表型测定,为与其他肿瘤相鉴别,对精原细胞瘤、间变性大细胞性淋巴瘤、母细胞型套细胞淋巴瘤部分病例检测AE1/3、PLAP、CD30、ALK、CD5和CyclinD1。结果 22 例患者均为原发DLBCL,男性14例,女性8例,年龄21~71岁,平均48岁;13例结内,9例结外。生发中心细胞(CGB)型13 例(结内7例,结外6例),非CGB(non-CGB)型9例(结内6例,结外3例),结合临床和组织形态学17例可诊断,再结合免疫组织化学22例均可诊断。结论 DLBCL形态学、免疫表型及临床表现有一定的特征性,三者相结合能较准确诊断。 相似文献
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目的 分析总结中国儿童各类型侵袭性成熟B细胞淋巴瘤的临床病理学及分子遗传学特点,为其诊断的标准化提供依据。方法 收集97例儿童侵袭性成熟B细胞淋巴瘤石蜡包埋组织标本,包括伯基特淋巴瘤(BL)81例、弥漫大B 细胞淋巴瘤(DLBCL)8例、介于BL和DLBCL间的不能分类的B细胞淋巴瘤(BL/DLBCL)8例,利用免疫组织化学技术和间期荧光原位杂交(FISH)技术检测其免疫表型和分子遗传学特征。结果 BL的bcl-2和MUM1的阳性率分别为3 %(2/66)和17 %(12/71),DLBCL分别为50 %(4/8)和63 %(5/8),BL/DLBCL分别为 50 %(4/8)和63 %(5/8)。BL、DLBCL 和BL/DLBCL 的Ki-67平均值分别为(93±4.4)%、(83±14.3)%和(80±11.5)%。BL、DLBCL 和BL/DLBCL 的c-myc 基因易位的比例分别为98 %(79/81)、38 %(3/8)和50 %(4/8)。38 %(3/8)的DLBCL和25 %(2/8)的BL/DLBCL 存在bcl-6基因的多拷贝,BL与DLBCL 之间、BL与BL/DLBCL之间bcl-2、MUM1和 Ki-67平均值的差异及c-myc基因易位和bcl-6基因多拷贝的差异均有统计学意义(均P<0.05)。结论 儿童侵袭性成熟B细胞淋巴瘤的诊断和分型需要综合分析形态学、免疫表型和分子遗传学特征。儿童BL/DLBCL 可能是DLBCL 的一个亚型。CD+10、bcl-6+、bcl-2-、Ki-67>90 %、伴有IGH/c-myc重排、不伴有bcl-2和bcl-6重排时,支持BL的诊断;bcl-2+、Ki-67 为50 %~90 %,同时伴有bcl-6基因的多拷贝时,支持 DLBCL或BL/DLBCL 的诊断。 相似文献
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目的 分析新疆维吾尔自治区汉族、维吾尔族老年人EB病毒(EBV)阳性弥漫大B细胞淋巴瘤(DLBCL)的临床特征及预后影响因素.方法 回顾性分析新疆维吾尔自治区人民医院病理科250例DLBCL患者中EBV阳性患者的临床资料,应用免疫组织化学技术和原位杂交方法分别进行组织学分型和EBV检测.结果 250例DLBCL患者中,EBV阳性DLBCL老年患者36例(年龄≥60岁28例),其中汉族21例,维吾尔族15例,男女比为2:1;结内病变23例,结外13例.Ann Arbor分期中Ⅰ、Ⅱ期7例,Ⅲ、Ⅳ期29例;血清乳酸脱氢酶升高30例,国际预后指数中-高危险度22例.组织形态学观察:淋巴结及结外组织正常结构破坏,炎性背景中可见弥漫浸润的中心母细胞、免疫母细胞及R-S样巨细胞.免疫组织化学分析:CD20/CD79a强阳性,Ki-67高表达.依据CD10、bcl-6、Mum-1进行组织学分型,非生发中心型31例.新疆维吾尔自治区汉族、维吾尔族老年人EBV阳性DLBCL的年龄和发病部位差异具有统计学意义(P<0.05),其余临床指标及组织学分型差异均无统计学意义(P>0.05).结论 新疆维吾尔自治区汉族、维吾尔族老年人EBV阳性DLBCL发病率低,具有DLBCL独特的临床病理亚型,预后不良,且发病与EBV有一定关系. 相似文献
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纵隔灰区淋巴瘤(mediastinal gray zone lymphoma)作为一个疾病实体,常不能依据现有的诊断标准进行分类。这类淋巴瘤同时具有纵隔弥漫大B细胞淋巴瘤(PMBL)和经典霍奇金淋巴瘤(cHL)的特征。在2008年WHO造血与淋巴组织肿瘤分类中将其命名为“B细胞淋巴瘤,不能分类,具有介于弥漫大B细胞淋巴瘤和经典霍奇金淋巴瘤之间的特征(BCLu)”。BCLu具有独特的临床特点、免疫表型和分子遗传学特征,临床过程更具侵袭性,预后较差。目前尚无达成共识的治疗方案,可参照侵袭性B细胞淋巴瘤的方案化疗。 相似文献
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Lloyd T Lam R Eric Davis Jackie Pierce Michael Hepperle Yajun Xu Maria Hottelet Yuhua Nong Danyi Wen Julian Adams Lenny Dang Louis M Staudt 《Clinical cancer research》2005,11(1):28-40
Constitutive activation of the NF-kappaB pathway is required for survival of the activated B cell-like (ABC) subgroup of diffuse large B-cell lymphoma (DLBCL). Here we show that a small molecule IkappaB kinase (IKK) inhibitor, PS-1145, and related compounds are toxic for ABC DLBCL cell lines but not for cell lines derived from the other prevalent form of DLBCL, germinal center B cell-like DLBCL. Treatment of ABC lines with these inhibitors rapidly induced a series of gene expression changes that were attributable to cessation of constitutive IKK activity, similar to changes induced by acute expression of genetic inhibitors of NF-kappaB, confirming the effectiveness and specificity of this compound. Before cell death, inhibition of IKK also induced features of apoptosis and an arrest in the G1 phase of the cell cycle. To test further the specificity of this toxicity, an inducible form of NF-kappaB was created by fusing the p65 NF-kappaB subunit with the ligand-binding domain of the estrogen receptor (p65-ERD). In the presence of tamoxifen, p65-ERD reversed the toxicity of IKK inhibition and restored expression of many NF-kappaB target genes. Another subgroup of DLBCL, primary mediastinal B-cell lymphoma (PMBL), also expresses NF-kappaB target genes, and treatment of a PMBL cell line with an IKK inhibitor was toxic and induced gene expression changes of a distinct group of NF-kappaB target genes. These studies validate the NF-kappaB pathway as a promising therapeutic target in ABC DLBCL, PMBL, and other lymphomas that depend on the activity of NF-kappaB for survival and proliferation. 相似文献
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Naoki Wada Masaharu Kohara Hiroyasu Ogawa Haruo Sugiyama Shirou Fukuhara Yoichi Tatsumi Akihisa Kanamaru Masayuki Hino Yuzuru Kanakura Eiichi Morii Katsuyuki Aozasa 《Case reports in oncology》2009,2(3):194-202
Change of CD20 expression was examined in cases of diffuse large B-cell lymphoma (DLBCL). CD20 expression after treatment with anti-CD20 antibody (rituximab, Rx) for DLBCL was examined in 23 cases who received serial biopsy by immunohistochemistry (IHC) and flow cytometry (FCM). CD20– by IHC and/or FCM was defined as CD20–. Four cases were CD20– at initial biopsy but became CD20+ after chemotherapy with Rx (CH-R) (group A). Recurrent tumors in three group A cases became resistant to CH-R. Initial and recurrent tumors were CD20+ before and after CH-R in 17 cases (group B). Tumors before CH-R were CD20– in two cases (group C) and continued to be CD20– in one and turned CD20+ in the other with survival time after the relapse of 8 and 23 months, respectively. Evaluation of CD20 expression with immunohistochemical and flow cytometric methods is used for the prediction of responsiveness of relapsed DLBCL for CH-R.Key Words: Diffuse large B-cell lymphoma, CD20, Rituximab, Relapse, Clonality 相似文献
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BACKGROUND: We studied the clinicopathological characteristics and prognoses of localized stage thyroid diffuse large B-cell lymphoma (DLBCL). PATIENTS AND METHODS: This study included 32 patients with stage I/IIE thyroid DLBCL. Their median age was 66 years, the male/female ratio was 10/22. RESULTS: As to the cellular immunophenotype, CD20 was positive in 31/32, CD5 in 0/32, CD10 in 4/32, CD23 in 1/32, BCL2 in 14/30, and BCL6 in 24/32. Twelve cases showed abnormal karyotypes: two cases with t(8;14)(q24;q32), four cases with 3q27, two cases with 17p11, and four cases with other abnormal karyotypes. As for treatment, eight cases were treated with chemotherapy alone and 24 cases were treated with chemotherapy followed by radiotherapy. Complete response was achieved in 94%. The 5-year progression-free survival was 84% and the 5-year overall survival was 90% with a median follow-up period of 62 months. The germinal center B-cell (GCB) type had a significantly better prognosis than the non-GCB type. CONCLUSION: Localized stage thyroid DLBCL is a disease with a relatively good prognosis. It is, however, a heterogeneous disease with regard to histological type and pathological state. Localized stage thyroid DLBCL has a good prognosis and it is that there are more GCB-type DLBCL lymphomas. 相似文献
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K Dunleavy C Grant FC Eberle S Pittaluga ES Jaffe WH Wilson 《Current hematologic malignancy reports》2012,7(3):241-247
Although primary mediastinal large B-cell lymphoma (PMBL) and classic Hodgkin lymphoma of the nodular sclerosis type (CHL-NS) are distinct diseases, they share several clinical characteristics and biologic features. Given that, it is not surprising that there exist mediastinal lymphomas that do not fit well into either category but have clinical and morphologic features overlapping and transitional between PMBL and CHL-NS. The term mediastinal gray zone lymphoma (MGZL) has been used for these tumors, which are included in the World Health Organization classification as "B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classic Hodgkin lymphoma." Although several studies have evaluated different therapeutic strategies in PMBL and CHL-NS, there is a paucity of prospective experience treating MGZL, given its rarity and relatively recent recognition. Historically, diseases that today would be categorized as MGZL were probably called "anaplastic large-cell lymphoma Hodgkin-like," and their outcome with standard approaches was poor, with short overall survivals. In this review-following a discussion of the biology and clinical features of MGZL, and how they compare to PMBL and CHL-NS-we outline how the treatment of PMBL and CHL-NS has evolved in recent years, and how we believe MGZL should be approached therapeutically. 相似文献