间变性大细胞淋巴瘤的临床病理分析

目的探讨间变性大细胞淋巴瘤的临床病理特点、免疫表型及鉴别诊断。方法对8例淋巴结及皮肤的间变性大细胞淋巴瘤组织学观察及免疫组化染色（ABC法），并复习相关临床资料。结果8例间变性大细胞淋巴瘤患者男性5例，女性3例，年龄12—53（平均34）岁。6例发生于淋巴结，2例发生于皮肤。组织学特征：部分或全部淋巴结受累，瘤细胞有成巢或沿淋巴窦内生长现象，发生于皮肤者肿瘤组织弥漫成片分布，瘤细胞高度异型、多形，核分裂象多见。免疫表型：8例瘤细胞均表达CD30，6例表达CD3或CD45RO，而CD15和CD20均阴性。结论间变性大细胞淋巴瘤是一种形态学高度异形、免疫表型特异，而临床预后相对较好的淋巴瘤。组织学上需与转移癌、恶性黑色素瘤及霍奇金淋巴瘤相鉴别。CD30免疫组织化学标记在鉴别诊断中具有重要价值。

A clinicopathological study of anaplastic large cell lymphoma

Objective: To explore the clinicopathological characteristics,immunophenotype and differential diagnosis of anaplastic large cell lymphoma(ALCL).Methods: Histological and immunohistochemical methods(ABC method) were used to analyse 8 cases of ALCL located in the skin and in the lymphoid node,and the correlated clinical data were reviewed.Result: The age of 8 patients(5 men and 3 women) ranged from 12 to 53 years(average age 34 years).6 tumors were presented in the lymphoid node,and 2 in the skin.Histopathologically,the lesion was involved in part or whole areas of the lymphoid node,tumor cells were arranged in the nest or grown in lymphoid sinuses,tumor tissue presented in the skin was distributed diffusely.tumor cells was high pleomorphism and pleomorphic,mitotic figures were commonly encountered.Immunohistochemically,of the 8 patients,tumor cell displayed positive antigen expression of CD30 in all cases,positive CD3 or CD45RO in 6 cases,but negative CD15 and CD20 in all cases.Conclusion: Anaplastic large cell lymphoma was a group of lymphomas showing high pleomorphism in morphology,specificity in immunophenotype,and better outcome in prognosis.Histopathologically,it should be differentiated with metastatic carcinoma,malignant melanoma and Hodgkin's lymphoma.CD30 has a important role in the differential diagnosis.