原发性中枢神经系统淋巴瘤的组织病理学与免疫组化特征

目的　探讨原发性中枢神经系统淋巴瘤 (PCNSL)的组织病理学特征和免疫组织化学特征。方法　回顾性分析 35例PCNSL的组织病理学特征并进行随访 ,应用单克隆抗体LCA、CD2 0、GFAP、CD4 5RO、PC进行免疫组织化学染色。结果　本组所有 35例淋巴瘤细胞在脑组织中呈弥漫性生长 ,分布疏密不均 ,但无滤泡形成 ,肿瘤内血管不同程度增生 ,2 1例 (6 0 % )可明显见到淋巴瘤细胞聚集在血管周围呈袖套样分布和多层环状向心性排列。本组发现弥漫性大B细胞淋巴瘤 32例、淋巴浆细胞性淋巴瘤 2例、弥漫性大T细胞淋巴瘤 1例。结论　PCNSL的组织病理学形态存在异质性 ,免疫组织化学染色可以确定淋巴瘤细胞的干系分化 ,达到相互鉴别的目的

Histopathological and immunohistochemical features of primary central nervous system lymphoma

Objective To explore the histopathologicaland immunohistochemical characteristics of primary central nervous system lymphoma(PCNSL). Methods The histopathological features of 35 PCNSL patients were analyzed retrospectively. Immunohistochemical staining was performed using monoclonal antibody, LCA and CD20 for B lymphocytes, CD45RO for T lymphocytes, PCfor lymphoplasmacytic lymphocytes, and GFAP for gliocytes. Results Tumor cells of PCNSL infiltrated well beyond the microscopic margin. In some cases, cell distribution of lymphoma were only perivascular (60%). The most common immunohistological subtype was diffuse large B cell lymphoma (DLBL)(91.42%) from high-grade malignance based on the WHO Classification of Tumors. There were only two cases of lymphoplasmacytic lymphoma (5.71%) and a diffuse large T-cell lymphoma (2.86%) according to the immunohistochemical study. Conclusion The histopathological appearance of PCNSL may vary considerably from case to case. The investigation of histopathological features and producing immunohistochemical technique in PCNSL are useful for diagnosis, and can delineate distinctive polarization of morphologic subtypes.