胃肠道原发B细胞性淋巴瘤的病理学特征及播散机制

目的研究胃肠道原发B细胞性淋巴瘤的病理学特征及淋巴细胞归巢受体CD44在其播散中的作用。方法对199例胃肠道原发B细胞性淋巴瘤进行病理组织学及免疫组化研究。结果胃肠道原发B细胞性淋巴瘤以DL(70.9%)发病率最高，MALT淋巴瘤(9.5%)次之。LN1染色在MALT淋巴瘤、MZC均为核周点状阳性。1例MLP肿瘤细胞LN1染色特性及形态学特征与MALT淋巴瘤相同。199例中单克隆性cIg检出率为49.7%，在MALT淋巴瘤为100%。临床Ⅲ、Ⅳ期组的CD44阳性率明显高于Ⅰ、Ⅱ期组(P<0.001)；在全身弥漫播散病例CD44阳性率高于MALT内播散者。结论MALT淋巴瘤来源于MZC，其惰性生物学行为与细胞来源有关。MLP除可为多中心起源的套细胞来源外，也可是MALT淋巴瘤晚期扩散的结果。cIg检测有助于胃肠道淋巴组织良恶性疾病的鉴别诊断。CD44表达与淋巴瘤的血道播散密切相关。

The pathological characteristics and dissemination mechanism of primary B cell lymphoma of the gastrointestinal tract

Objective　To investigate pathologic characteristi cs and mechanism of dissemination of primary B cell lymphoma of the gas tro intestinal tract.Methods　A detailed histopathologic and immunoh istochemical study had been carried out on 199 cases.Results　Of 199 cases the highest incidence was found in DL(70.9%),followed by MALT lymphom a (9.5%).Positive perinuclear dot for LN1 was found in MALT tumor cells and MZC.The chara cteristics of LN1 staining and morphology observed in 1 case of MLP were as same as those of MALT lymphoma.Monoclonal cIg was found in 49.7% cases of 199 case s and 100% in MALT lymphoma.CD44 positive ratio was higher in clinical stageⅢ、Ⅳ than in stage Ⅰ、Ⅱ(P<0.001),also it was higher in systemically disseminated AMLT lymphoma than restrictedly disseminated MALT cases.Conclusions　MALT lymphoma is accomanied by in indolent biological behavior,due to its origin from MZC.CD44 is involved in the dissemination of lymphoma by blood.