30例原发性小肠淋巴瘤病理分析

目的：研究原发性小肠淋巴瘤（PSIL）的病理特点。方法：对30例PSIL患者的组织标本行苏木精-伊红（HE）染色、免疫组化检查,其中2例行基因重排检查,并结合文献进行分析。结果：30例PSIL患者的病理诊断均为非霍奇金淋巴瘤（NHL）,其中B细胞来源23例（76.7%）、T细胞来源7例（23.3%）。其组织学类型分别为弥漫大B细胞淋巴瘤16例（53.3%）、黏膜相关淋巴组织（MALT型）B细胞淋巴瘤7例（23.3%）、外周T细胞淋巴瘤6例（20.0%）、自然杀伤（NK）/T细胞淋巴瘤1例（3.4%）。免疫组化结果示,30例PSIL均表达CD45,AE1/AE3均阴性,4例B细胞淋巴瘤EMA弱阳性。23例B细胞淋巴瘤均表达CD20和CD79α,7例T细胞淋巴瘤均表达CD3和CD45RO。NK/T细胞淋巴瘤还表达CD56和TIA-1。16例弥漫大B细胞淋巴瘤有6例（37.5%）表达Bcl-2蛋白,10例（62.5%）表达MIB-1。7例MALT型B细胞淋巴瘤中有5例（71.4%）表达Bcl-2,1例（14.3%）表达MIB-1。基因重排结果示,2例B细胞淋巴瘤均呈Fr2A、Fr3A阳性,TcR阴性。结论：PSIL大多为B细胞来源的NHL,最常见的组织学类型是弥漫大B细胞淋巴瘤。Bcl-2、MIB-1的阳性率与肿瘤病理分型相关。

Pathologic analysis of 30 cases of primary small intestinal lymphoma

Objective To study the pathologic characteristics of primary small intestinal lymphoma （PSIL）. Methods Thirty cases of PSIL were examined by HE and immunohistochemical staining, and the related literatures were reviewed. Gene rearrangement examination was performed in 2 cases. Results All these 30 cases were diagnosed as non-Hodgkin’s lymphoma, of which 23 （76.7%） were B-cell in origin and 7（23.3%） were T-cell in origin. For histological subtypes, 16 cases （53.3%） were diagnosed as diffuse large B cell lymphoma, 7 cases （23.3%） as B-cell mucosa-associated lymphoid tissue （MALT） lymphoma, 6 cases （20.0%） as peripheral T cell lymphoma and 1 case （3.4%） as NK/T cell lymphoma. Immunohistochemical examination showed that CD45 was expressed in all these 30 cases and AE1/AE3 was negative. EMA was weakly expressed in 4 cases of B-cell lymphoma. CD20 and CD79α were expressed in all 23 cases of B-cell lymphoma. CD3 and CD45RO were expressed in all 7 cases of T-cell lymphoma. CD56 and TIA-1 expression could be found in NK/T cell lymphoma. Of 16 cases of diffuse large B cell lymphoma, the positive rates of Bcl-2 and MIB-1 were 37.5%（6/16） and 62.5%（10/16）, respectively; whereas in 7 cases of B-cell MALT lymphoma, the corresponding number were 71.4%（5/7） and 14.3%（1/7）. Gene arrangement examination in 2 cases of B cell lymphoma showed Fr2A and Fr3A positive and TcR negative. Conclusions Most of PSIL were B-cell in origin and diffuse large B cell lymphoma was commonly seen. The positive rates of Bcl-2 and MIB-1 had some correlation with the histological subtypes of this lymphoma.