IGF-1在胃癌组织中的表达及其与浸润转移的关系

[目的]探讨睾丸非霍奇金淋巴瘤的临床病理特征。[方法1对9例睾丸非霍奇金淋巴瘤手术标本进行光镜观察、免疫组化EnVision法检查．结合文献对其临床病理特点进行分析。[结果]患者中位年龄62岁。临床主要表现为睾丸无痛性肿大,病变位于左侧6例,右侧2例。双侧1例。组织学分型：7例为弥漫大B细胞淋巴瘤。1例套细胞淋巴瘤,1例为继发性鼻型NK/T细胞淋巴瘤。[结论]睾丸非霍奇金淋巴瘤中老年患者多见,表现为无痛性进行性睾丸肿大,主要类型为非霍奇金弥漫性大B细胞性淋巴瘤,确诊依赖于病理组织学和免疫组化检查。     

间变性大细胞淋巴瘤的临床病理特征合并文献复习

目的：目的探讨间变性大细胞淋巴瘤的临床病理学特点及诊断要点。方法回顾性分析3例间变性大细胞淋巴瘤的临床资料、病理形态学及免疫组化特征,并结合文献对其诊断及鉴别诊断进行探讨。结果镜下见肿瘤细胞弥漫分布,排列疏密不一,形态多样。肿瘤细胞体积较大,异型性明显,细胞界限尚清,呈圆形或多边形,胞质丰富,胞核大,常呈马蹄形,染色质呈粗颗粒状或为弥漫细颗粒状,核分裂象较多见。免疫组化显示：CD30表达均阳性, CD20、CD79α、Pax-5表达均阴性,符合间变性大细胞淋巴瘤。结论掌握间变大细胞瘤淋巴瘤的病理特点,提高对间变性大细胞淋巴瘤的认识,对其避免误诊是至关重要的。     

睾丸非霍奇金淋巴瘤9例临床病理学分析

[目的]探讨睾丸非霍奇金淋巴瘤的临床病理特征。[方法]对9例睾丸非霍奇金淋巴瘤手术标本进行光镜观察、免疫组化EnVision法检查,结合文献对其临床病理特点进行分析。[结果]患者中位年龄62岁。临床主要表现为睾丸无痛性肿大,病变位于左侧6例,右侧2例,双侧1例。组织学分型:7例为弥漫大B细胞淋巴瘤,1例套细胞淋巴瘤,1例为继发性鼻型NK/T细胞淋巴瘤。[结论]睾丸非霍奇金淋巴瘤中老年患者多见,表现为无痛性进行性睾丸肿大,主要类型为非霍奇金弥漫性大B细胞性淋巴瘤,确诊依赖于病理组织学和免疫组化检查。     

阑尾原发Burkitt淋巴瘤临床病理观察

目的：探讨阑尾原发Burkitt淋巴瘤（BL）的临床病理特点、免疫表型及分子生物学特征。方法：运用组织形态及免疫组化,EB病毒（EBER）原位杂交方法研究1例发生在阑尾的Burkitt淋巴瘤,并结合文献进行分析讨论。结果：阑尾Burkitt淋巴瘤（BL）形态学表现为肿瘤细胞弥漫一致性增生的中等大小细胞浸润,部分瘤细胞周围空晕伴有星空现象。免疫组化显示,肿瘤细胞LCA,CD20及CD10均为阳性,Ki-67大于80%阳性,CD99,CD3p,Mpo阴性,原位杂交EBER阴性。结论：原发于阑尾Burkitt淋巴瘤（BL）非常罕见,属高度侵袭性。应与其他类型淋巴瘤相鉴别,需结合组织形态及免疫组化,原位杂交等为临床诊断和及时治疗提供依据。     

肺黏膜相关淋巴组织淋巴瘤临床病理观察

目的：探讨肺黏膜相关淋巴组织淋巴瘤的临床病理特点及诊断与鉴别诊断。方法：对4例肺黏膜相关淋巴组织淋巴瘤的临床资料、组织学形态及免疫组化结果进行分析。结果：肿瘤大体呈结节状,镜下见边缘区B细胞结节样增生,并向周围肺泡和肺泡间质弥漫性浸润,形成特征性的飘带样和串珠样结构。免疫组化标记,肿瘤细胞CD20、CD79a、Igλ、BCL-10阳性,CD3、CD45RO、CD5、CD23、CyclinD1、CD10、BCL-2阴性。结论：肺的黏膜相关淋巴组织淋巴瘤较为少见,组织形态特征是其诊断的主要依据,免疫组化有助于鉴别诊断。     

胃MALT型淋巴瘤12例临床病理分析

目的：探讨胃MALT型淋巴瘤的临床病理特点,为诊断和治疗提供依据。方法：分析12例胃MALT型淋巴瘤的临床、病理形态学特点和免疫组化表达。结果：患者男女比例为1．40：1,中位年龄56岁。结论：胃MALT型淋巴瘤是结外最常见的一种低度恶性B细胞淋巴瘤,好发于老年人。     

梭形细胞变异型弥漫性大B细胞淋巴瘤1例报道及文献复习

目的：探讨梭形细胞变异型弥漫性大B细胞淋巴瘤的临床病理特征、病变性质及鉴别诊断要点。方法：对1例梭形细胞变异型弥漫性大B细胞淋巴瘤的组织形态特征、免疫组化表型，结合临床预后进行分析。结果：1例23岁女性患者在半年内先后发生结肠肿瘤和乳腺肿瘤。HE切片显示肿瘤细胞弥漫性浸润肠壁和乳腺组织，瘤细胞有异型性和核分裂，并伴有显著的梭形细胞特征。免疫表型显示瘤细胞CD45 ，CD20 ，CD45RO-，CD30-，Vim ，Des-，SMA-，S-100-，CK-，EMA-。患者1年内死于肿瘤。结论：本例梭形细胞变异型大B细胞淋巴瘤是一种罕见的高度恶性肿瘤，在缺乏免疫组化标记的情况下易误诊为肉瘤或低分化癌。     

20例胃肠道粘膜相关淋巴瘤的临床病理分析

目的　探讨胃肠道MALT淋巴瘤的病理特征及其与临床的联系。方法　收集 2 0例胃肠道MALT淋巴瘤 ,采用病理组织学和免疫组化标记技术对其进行临床及病理资料分析。结果　 2 0例胃肠道MALT淋巴瘤中 ,男性发病率高于女性 ,男女比率 2 3∶1。平均年龄 48 2岁 ( 2 2～ 65岁 )。临床表现无特异性。发病部位以贲门最多见 ,其次为回盲部。病理学以低度恶性淋巴瘤多见 ,经免疫组化标记证实全部为B细胞性淋巴瘤。结论　本病误诊率较高 ,应尽量使用免疫组化技术对其进行鉴别诊断 ,必要时可借助电镜及基因表型分析。抗幽门螺旋杆菌的治疗应引起足够认识。     

原发性中枢神经系统弥漫性大B细胞淋巴瘤临床病理诊断并相关文献复习（附4例）

目的:探讨原发性中枢神经系统弥漫性大B细胞淋巴瘤(primary central nervous system diffuse large B cell lymphoma,PCNS-DLBCL)的临床病理学特点。方法:对4例原发性中枢神经系统弥漫性大B细胞淋巴瘤的临床表现、大体、组织学特征及免疫组化等进行观察，并复习相关文献。结果:患者男性1例，女性3例，平均年龄56.25岁；病变均位于幕上，临床表现多样，MRI表现具有一定特异性。肿瘤细胞呈圆形、卵圆形，中等偏大，可见核仁，核分裂象多见，可见病理性核分裂，有坏死，肿瘤细胞亲血管生长形成淋巴细胞血管套。免疫组化示肿瘤细胞表达B细胞相关抗原，4例均表达CD20(+），Ki-67平均增殖指数为 70%。结论:原发性中枢神经系统弥漫性大B细胞淋巴瘤是一种罕见恶性肿瘤，预后差，诊断应结合临床资料及影像学检查，并需与多种良、恶性肿瘤相鉴别。目前治疗首选大剂量甲氨蝶呤为基础联合利妥昔单抗的化疗方案，辅以全脑放疗、自体干细胞移植等巩固治疗。     

脾脏血管内大B细胞淋巴瘤1例报道及文献复习

目的：探讨脾脏血管内大B细胞淋巴瘤的临床病理学特征及鉴别诊断。方法：对1例脾脏血管内大B细胞淋巴瘤进行临床特点、病理形态学和免疫表型分析。结果t患者女性52岁，临床以反复发热、恶性贫血和脾肿大为特点。病理检查：脾脏多灶性贫血性梗死，坏死组织内和坏死组织边缘区的中小血管腔内充满非黏附性肿瘤细胞。肿瘤细胞免疫表型显示：淋巴细胞标记CD45、CD20、CIy79a阳性，CD45RO和CD3阴性；上皮源性标记CKpan、CKl8、EMA阴性；黑色素瘤标记HMB45、S100阴性。Ki67阳性细胞指数约70％。结论：脾脏原发性血管内大B细胞淋巴瘤罕见，临床诊断非常困难，确诊主要依赖对病变组织的病理形态检查和免疫组化标记，患者预后差。     

Clinical pathological analysis of nasal natural Killer/T-cell lymphoma patients

purpose To investigate the clinicopathological characteristics, differential diagnosis and biological characteristics of patients with natural killer (NK)/T-cell lymphoma of the nasal cavity. method To collect 17 patients with nasal NK/T cell lymphoma from Department of Pathology, Affiliated Hospital of Yangzhou University from September 2007 to July 2017, summarize the clinical symptoms, observe the pathological changes and immunophenotype, and combine the literature analysis. result Clinical symptoms of patients with nasal NK/T cell lymphoma are insidious and often presented with nasal congestion, runny nose, and bloody sputum. Pathological examination showed marked necrosis and varying degrees of inflammatory background. Hepatic neoplastic lymphocytes were seen in the inflammatory background. The nucleus was irregularly distorted or folded. The nucleolus was not obvious, the mitotic figures were visible, and the tumor cells grew as blood vessels. It can infiltrate and destroy blood vessels. In the above background, normal morphological lymphocytes, plasma cells, and tissue cells can be seen. Tumor cells expressed CD3, CD43, CD56, TIA-1, granzyme B, perforin, and other markers, and the EB virus was positive by in situ hybridization. in conclusion Patients with nasal NK/T cell lymphoma are rare, highly invasive clinically, have a high recurrence rate, have a poor prognosis, and are prone to misdiagnosis. They need differential diagnosis using immunohistochemistry. Treatment is based on radiotherapy and chemotherapy. © 2018 Chinese Medical Association Publishing House Co. Ltd. All rights reserved.     

Mantle cell leukemia, prolymphocytoid type: a rarely described form

Leukemic manifestations of mantle cell lymphoma are seen in a minority of cases, usually associated with extensive tumor. Usually the neoplastic cells in the peripheral blood resemble mantle cells with a mature chromatin pattern and irregular nuclear contours, or less frequently with a more "blastic" chromatin pattern. A prolymphocytic leukemia with t(11;14)(q13;q32) has previously been reported; however, a complete flow cytometric immunophenotypic profile was lacking. Mantle cell leukemia, prolymphocytoid type with complete flow cytometric data has not previously been described and is the purpose of this report. We report such a case in a 90 year-old female who presented with an elevated white blood cell count. The diagnosis was based on flow cytometric immunophenotyping and the cytomorphology of the peripheral blood combined with cyclin D1 immunohistochemical staining of the bone marrow. We describe our findings and her clinical course in order to heighten awareness of this previously rarely described entity.     

Glucocorticoid-induced redistribution lymphocytosis in mantle cell lymphoma with hyaline vascular Castleman disease-like features

We report a case of mantle cell lymphoma mimicking Castleman disease. A 76-year-old man presented with generalized lymphadenopathy, splenomegaly, anemia, polyclonal gammopathy, and pulmonary infiltrations. Lymph node biopsy revealed histological features of hyaline vascular Castleman disease. Treatment with prednisolone induced lymphocytosis with immunophenotypic and genetic features of mantle cell lymphoma. A detailed immunohistochemical study of the lymph node demonstrated a mantle cell lymphoma-mantle zone growth pattern. Glucocorticoid-induced distribution lymphocytosis has not been reported in mantle cell lymphoma. Careful observation of circulating lymphocytes during steroid treatment may enable diagnosis of the underlying occult lymphoma in a subset of patients exhibiting clinical manifestations of Castleman disease.     

四例肾球旁细胞瘤的临床病理学观察

目的 观察肾球旁细胞瘤(JGCT)的临床特征、形态特点、免疫表型,明确其诊断、鉴别诊断、组织发生及预后。方法 对4例组织标本采用光镜观察,PAS、Sweet嗜银组化染色,免疫组化检测CK8、E-cadherin／CK7、CD10、Vim、Actin、desmin、calponin、CD34、HMB45、CD31、S100、Chr、Syn及CD117。电镜观察超微结构。对患者进行随访。结果 4例JGCT患者临床表现为青年人难以控制的严重高血压。肿瘤包膜完整、体积较小。镜下肿瘤细胞以片状排列为主,当有肾小管结构时可见乳头、葱皮样排列;间质含丰富的薄壁血管及少量的厚壁血管;瘤细胞偏小,多角或短梭形,轻度嗜酸,胞膜不清,可见核异型及核分裂相;肿瘤内见多量的肥大细胞,3例见小管结构,并表达远端小管标志物E-cadherin／CK7。肿瘤细胞Vim、Actin、CD34均为( );4例标本电镜下均见特征性的菱形结晶。患者均无复发和转移。结论 JGCT青年人多见,有严重的高血压。病理为独特的形态及超微结构,免疫表型Vim、Actin、calponin、CD34阳性,发生于肾球旁细胞,是独立类型的肾良性间叶肿瘤。     

免疫母细胞性淋巴结病样T细胞性淋巴瘤

目的 ＩＢＬ样Ｔ淋巴瘤属高度恶性肿瘤，由于其细胞成份的多样笥，病理组织学上很易误诊为良性病变。现将９例报告如下。方法 全部病例做病理组织学及免疫组化（ＡＢＣ法）检测。结果 组织学上最显著的特征是血管旁胞浆淡染透明的透明细胞显著增生，２例呈现弥漫增生，７例呈现小灶状增生。小至中等大的异型核细胞散在于小灶状增生的透明细胞周围。     

眼眶MALT淋巴瘤临床病理及形态定量研究

对5例眼眶MALT恶性淋巴瘤(均为男性,平均年龄55.4岁)进行临床病理、免疫组化及形态定量测定研究.标本采用常规石蜡切片,HE染色及ABC法免疫组化染色,用HPIAS-1000彩色图像分析系统对肿瘤细胞核的形态进行定量测定.5例均为小淋巴细胞型恶性淋巴瘤,免疫组化染色瘤细胞表达均为LCA和L26阳性,形态定量测定表明肿瘤细胞与对照组间14项参数具有高度显著性差异(p＜0.001).说明免疫组化染色及形态定量测定对眼眶恶性淋巴瘤的诊断和鉴别诊断具有重要意义,形态定量测定为眼眶恶性淋巴瘤疑难病例的诊断提供了一种新的重要辅助诊断方法.     

Intravascular large cell lymphoma: clinicopathological, immuno-histochemical and molecular genetic studies.

Intravascular large cell lymphoma (IVLL) is a rare neoplasm characterized by a proliferation of lymphoma cells within the blood vessels. Its cell origin and clinicopathological characteristics have not been well understood. The study uses 5 male and 4 female patients who were diagnosed as having IVLL from 1978 to 1996. We examined cell lineage and adhesion molecules using immunohistochemical staining and performed a molecular analysis by using polymerase chain reaction (PCR) on the IgH gene, on T-cell receptor chain genes, and the Epstein-Barr virus (EBV) and in situ hybridization on EBV. The immunohistochemical and PCR results disclosed 8 cases of B- cell and one of T-cell lymphoma. Three of four cases whose frozen specimens were available expressed CD5. PCR showed EBV in 7 of 9 cases, although EBV was found by in situ hybridization in only 3 cases. Lymphoma cells express CD11a and CD49d (VLA-4), while endothelial cells expressed CD54 (CD11a ligand) and CD106 (CD49d ligand). Such interaction of these adhesion molecules might contribute to the intravascular proliferation of lymphoma cells. Furthermore, the CD5 expression of lymphoma cells suggests that IVLL most likely originates from a unique subtype of B cells, although their normal counterpart remains uncertain.     

112 例套细胞淋巴瘤临床病理分析*

目的:探讨套细胞淋巴瘤（mantle cell lymphoma,MCL ）的临床病理特点。方法:收集112 例MCL 的临床及病理资料,采用免疫组织化学（Envision二步法）行相关抗体标记,荧光原位杂交技术（fluorescence in situ hybridization,FISH）对其中24例作IgH/CCND1 基因断裂检测。结果:112 例（包括2 例多形性和母细胞变亚型）均表达B 细胞相关抗原,94.6%（106/112）表达cyclinD1,92.9%（104/112）表达CD5。不同免疫表型的经典型MCL 的Ki-67及平均生存期无统计学差异（P>0.05）。 3 例CD5-的MCL未检测出IgH/CCND1 基因断裂,2 例经典型MCL 检测出IgH/CCND1 多倍体。结论:MCL 是一种具有特殊免疫表型的B 细胞淋巴瘤,多形性及母细胞变异型的预后较差,对特殊亚型的MCL 诊断有必要细分。      

An overlapping case of in situ mantle cell neoplasia and leukemic non-nodal mantle cell lymphoma

In situ mantle cell neoplasia (isMCN) and leukemic non-nodal mantle cell lymphoma (nnMCL) are classified as an indolent subtype of mantle cell lymphoma (MCL). The tumor cells of isMCN are restricted to the inner layer of the lymphoid tissue mantle zone, exhibiting an in situ pattern histologically. On the other hand, nnMCL is distributed in the peripheral blood, bone marrow and sometimes the spleen, but lymphadenopathy or systemic organ involvement is rare. We report a case of isMCN in a submandibular lymph node resected from a 65-year-old Japanese male. The tumor cells were positive for cyclin D1 (CCND1) and SOX11 expression, and were restricted to the mantle zone area of the lymph node. However, tumor cells were also detected in the stomach mucosa, bone marrow tissue and peripheral blood, suggesting nnMCL. isMCN and nnMCL may have a partly overlapping disease spectrum, although the correlation between these two subtypes has not been well described. This present case demonstrated characteristics overlapping between isMCN and nnMCL.