多发性淋巴瘤性息肉病型套细胞淋巴瘤临床病理分析

目的 探讨大肠多发性淋巴瘤性息肉病(MLP)型套细胞淋巴瘤(MCL)的临床病理与免疫组化特点。方法 采用免疫组化EnVision法确定1例肠道MLP／MCL的免疫表型，抗体包括CD5、CD10、CD19、CD20、CD22、CD79α、bcl-6、bcl-2、CD23、CD43、cyclinD1等。结果 末端回肠、右半结肠、直肠分别见多发性息肉。镜下见肿瘤性淋巴细胞呈弥漫型及结节型生长。瘤细胞表达全B细胞标记，CD5 ，CD10-，cyclinD1 ，CD43 ，CD23-，bcl-6-，bcl-2 。结论 MLP是一种罕见的独特的胃肠道恶性淋巴瘤，几乎均为MCL，具有特殊的免疫表型，需与其他类型B细胞淋巴瘤鉴别。MLP具有侵袭性生物学行为，预后较差，应按中高级别恶性淋巴瘤给予系统性联合化疗。

Multiple lymphomatous polyposis type mantle cell lymphoma:a clinicopathologic study

Purpose To investigate the clinicopathological and immunohistochemical characteristics of mantle cell lymphomas (MCL) presenting as multiple lymphomatous polyposis (MLP). Methods The clinical presentation, histological features, immunohistochemical characteristics were analyzed in 1 case of MLP/MCL. Results A 78-year-old male patient presented multiple polyps which involved terminal ileum, right part of colon and rectum. Microscopically, neoplastic lymphocytes showed a diffuse and nodular growth pattern. The tumor cells expressed pan-B, CD5, cyclinD1, CD43 and bcl-2, but did not express CD23, bcl-6 and CD10. Conclusions MLP is a distinctive and particularly rare clinical type of malignant gastrointestinal lymphoma, which is classified as MCL, showing special immunophenotype. It should be distinguished from the other B cell lymphomas. MLP has an aggressive biologic behavior and a relatively poor prognosis and must be treated as a high-grade lymphoma with systemic chemotherapy.