纵隔原发性大B细胞性淋巴瘤一例定量病理分析

目的：本文对１例罕见的纵隔大Ｂ细胞淋巴瘤进行临床病理、免疫组化、病理形态及ＤＮＡ定量测定的研究。方法：采用常规ＨＥ染色及ＡＢＣ免疫组化染色，光镜观察；用ＨＰＩＡＳ－１０００彩色图像分析系统定量测定肿瘤细胞核的形态，以肿瘤周围残存的正常胸腺淋巴细胞作为对照。另对６μｍ厚Ｆｅｕｌｇｅｎ染色切片用ＩＣＭ１００细胞图像分析系统测定肿瘤细胞核的ＤＮＡ倍体。结果：见肿瘤细胞较大，呈弥漫分布，其间可见宽窄不一，成束或带状的纤维结缔组织穿插分割。免疫组化染色表明为Ｂ细胞性，瘤细胞表达ＬＣＡ及Ｌ２６阳性，ＩｇＡ及Ｋ弱阳性。肿瘤细胞形态定量测定结果显示瘤细胞核的１５项形态学参数与对照组间均有高度显著性差异（Ｐ＜０００１），经细胞影像仪测定瘤细胞ＤＮＡ呈高异倍体，ＤＮＡ质量分布呈高度异质性。结论：形态定量测定的方法对于恶性淋巴瘤的诊断能够提供客观的、准确的和定量的依据，并能帮助我们统一诊断标准，克服病理医师在诊断中的主观性和仅根据经验诊断而带来的误差，具有重要的意义。肿瘤细胞ＤＮＡ倍体测定结果对于患者预后判断具有重要的意义。

A quantitative morphological study on one patient's mediastinal primary large B cell lymphoma

Objective:This study was to investigate the clinicopathological,immunohistiochemical,quantitative morhpological and DNA ploidy characteristics of the mediastinal primaty large B cell lymphoma.Methods:The routine paraffin slides were stained with HE and immunochemical ABC methods.Then,the lymphoma cell nuclei were measured by the HPIAS1000 color pathology picture analysis system.The cells in the remaining thymus tissue around the tumor were selected as the normal control lymphocytes.In addition,the 6m thick paraffin slides were stained by Feulgen method.Then the DNA ploidy of tumor cells was measured with image cytometer ICM100 cell morphology analysis system.Results:Microscopically,the morphological characteristics of tumor cells were that the sheets of diffusely distributed large lymphocytes were penetrated by bundles of fibroconnective tissue.In immunohistochemically stained slides,the tumor cells expressed LCA and L26 positive,IgA and K weakly positive.The morphological measurement showed high great significant difference(P<0001) in the 15 items of morphologic parameters between lymphoma cells and the normal control lymphocytes.The DNA ploidy measurement showed that the tumor cells were highly aneuploidy and the distribution of DNA contents were highly heterogeneous.Conclusions:The morphometrical methods may offer us the objective,accurate and quantitative grounds for the diagnosis of malignant lymphoma.It can help us to unify the diagnostic criteria,to avoid the subjectivity and mistakes of pathologists in diagnosis only according to the experience.The results of the DNA ploidy measurement of the tumor cells suggest that it may have great significance iv prediction of the patients prognosis.