间变性大细胞淋巴瘤的临床细胞病理学分析

目的:探讨间变性大细胞淋巴瘤(anaplastic large cell lymphoma,ALCL)的临床细胞病理学特点、免疫表型及鉴别诊断,提高对ALCL的认识。方法:分析经组织病理学证实的13例ALCL的临床表现、细胞病理学形态及免疫表型,并结合相关文献进行讨论。结果:13例ALCL患者中,ALK阳性11例,ALK阴性2例;全部表达CD30,部分表达EMA、CD3、CD45RO、CD43,不表达CD3、CD56、CD20、CD79a、PCK、CD117;Ki67LI 60%~100%。结论:ALCL是一种少见的非霍奇金淋巴瘤,依据其细胞病理学形态特征,细胞病理学可以做出正确的诊断,但应注意与霍奇金淋巴瘤、弥漫大B细胞淋巴瘤、恶性黑色素瘤、未分化癌等进行鉴别;当鉴别诊断有困难时,应行活检及免疫组织化学染色以确诊。

Clinical analyses of Anaplastic large cell lymphoma through cytopathology

Objective：To explore the clinical cytopatbological features, immunophenotype and differential diag- nosis of anaplastic large cell lymphoma （ALCL） and improve the understanding of ALCL. Method：Thirteen cases of ALCL were diagnosed with histopathology. Their clinical manifestation, cytopathological mophology and immu- nophenotype were analyzed, and related literatures were involved and discussed. Result：In 13 cases of ALCLs, 11 cases were ALK-positive and 2 cases ALK-negative; all cases expressed CD30, part of them expressed EMA, CD3, CD45RO, and CD43; none o{ them expressed CD3, CD56, CD20, CD79a, PCK, CD117; Ki67LI 600/4- 100%. Conclusion：ALCL is a kind of non Hodgkin＇s lymphoma which is rarely seen and should be differentiated from Hodgkin lymphoma, diffuse large B cell lymphoma, malignant melanoma and undifferentiated carcinoma. Correct cytopathological diagnosis can be made on its morphological characteristics. When the differential diagno- sis is difficult, some assistive technology, such as biopsy and immunohistochemical staining, should be applied.