原发性睾丸淋巴瘤33例临床病理分析

目的探讨原发性睾丸淋巴瘤（PTL）的临床病理特征,以提高对该疾病的诊治水平。方法收集PTL存档资料33例,进行石蜡切片,常规HE染色,Envision二步法免疫组织化学标记,根据2008年版WHO淋巴与造血组织肿瘤病理学分类标准进行临床病理学分析。结果 PTL占同期睾丸恶性肿瘤的8.3%（33/397）。临床Ⅰ～Ⅱ期28例（85%）,Ⅲ～Ⅳ期5例（14%）。组织学分型：33例PTL中弥漫性大B细胞淋巴瘤25例（76%）,黏膜相关（MALT）淋巴瘤3例（9%）,B淋巴母细胞淋巴瘤1例（3%）,外周T细胞淋巴瘤2例（6%）,鼻型NK/T细胞淋巴瘤2例（6%）。所有患者均行患侧睾丸根治性切除术。术后随访6～120个月,生存时间6～80个月,平均生存28个月。结论 PTL类型多样,以弥漫性大B细胞淋巴瘤最多见。PTL确诊依赖于病理学检查。正确的病理诊断,明确免疫表型,进而制定相应的放化疗方案,可有效改善预后。

Clinical and Pathological Analysis of Primary Testicular Lymphoma

Objective To investigate the pathological characteristics of primary testicular lymphoma（PTL） retrospectively,and to analyze the clinical feature,and to improve the diagnosis and treatment level of PTL.Methods Clinical and microscopic features were assayed in 33 patients with PTL.Paraffin section and H-E staining,immunohistochemistry were used.Results PTL accounted for 8.3% of all malignant tumors of the testis in the same period.In all 33 cases,the patients of stage Ⅰ～Ⅱ were28（85%）,and the patients of stage Ⅲ～Ⅳ were 5（15%）.Histological classification：twenty-five（76%） patients suffered from diffuse large B-cell lymphoma,3（9%）patients suffered from MALT lymphoma,1（3%）patient suffered from precursor B lymphoblastic lymphoma,2（6%）patients suffered from peripheral T-cell lymphoma,and 2（6%）patients suffered from NK/T lymphoma,nasal type.All of the patients underwent with orchiectomy firstly.Follow-up time ranged from 6 to 120 months,and the survival time ranged from 6 to 80 months with a median survival time of 28 months.Conclusion The diagnosis of PTL is based on pathological examination and immunophenotype analysis.Diffuse large B-cell lymphoma is the predominant entity of PTL.Owing to the diagnosis usually was after operation in the most cases most cases operated,so the surgical treatment is firstly essential,and the chemotherapy and radiotherapy are also needed for improving survival.