富于T/组织细胞型的弥漫大B细胞性淋巴瘤的误诊分析

目的：探讨富于T细胞/组织细胞型的弥漫大B细胞性淋巴瘤（TCRBCL）的病理形态、预后和免疫组化的特点及鉴别诊断。方法：根据WHO淋巴瘤分类（2008版）的标准对4例TCRBCL进行临床、组织病理和免疫组化分析，应用全自动免疫组化仪（DAKO）检测瘤细胞及背景细胞的免疫表型，抗体包括CD20，CD79a， CD3，CD15，CD68，CD30、CD10，BCL-6，CD21。结果：少量肿瘤性大细胞分布于小淋巴细胞及组织细胞背景中，免疫组化肿瘤性大细胞CD20阳性，背景小细胞CD3阳性，组织细胞CD68阳性。结论：TCRBCL是一个独立的组织学类型，是弥漫大B细胞性淋巴瘤的形态学变异体，易误诊为霍奇金淋巴瘤、反应性淋巴组织增生、淋巴瘤样肉芽肿病等，诊断应结合形态学和免疫表型特征。

The Misdiagnosis of T Cell/Histocyte-rich B Cell Lymphoma

Objective：To explore pathological morphology, the prognosis, immunohistochemical features and differential diagnosis of T cell/histocyte-rich B cell lymphoma （TCRBCL）. Methods：Four cases of TCRBCL were analyzed from clinical, histopathological and immunohis chemical aspects according to the standard of WHO lym-phoma classification （2008 edition）, the immunophenotypes of tumor cells and background cells were detected by automatic immunohistochemical instruments （DAKO）, antibodies contained CD20, CD79a, CD3, CD15, CD68, CD30, CD10, BCL-6 and CD21. Results：There were a small amount of tumorous magacells distributed in the tis- 〈br〉 sues of small lymphocytes and histocytes, immunohistochemical tumorous magacells CD20 positive, background cellule CD3 positive, histocytes CD68 positive. Conclusion：TCRBCL is an independent histological type and mor-phological variant of B cell lymphoma, it might be misdiagnosed as hodykin lymphoma, reactive lymphadenia, lym-phomatoid granulomatosis and others, the diagnosis shoule be based on the morphology and the features of im-munophenotype.