伴皮肤侵犯的鼻NK/T淋巴瘤临床病理分析及免疫组化研究

目的　探讨伴皮肤侵犯的鼻NK T淋巴瘤病理形态学、免疫表型特征。方法　对 3例伴皮肤侵犯的鼻NK T淋巴瘤进行组织形态学观察 ,并行免疫组化检测。结果　 3例患者在确诊鼻NK T细胞淋巴瘤后数月内继发皮肤病变 ,并多在 1年内死亡。皮肤及鼻腔病变组织形态学有共同特征 ,免疫表型均符合结外鼻型NK T淋巴瘤特点 ,LCA、CD2、CD5 6和TIA 1(+) ,CD3胞质阳性 ,胞膜阴性。 3例中有 2例瘤细胞表达EBV ,瘤细胞增殖指数均 >85 %。结论　鼻NK T淋巴瘤是一种高度恶性肿瘤 ,易发生皮肤侵犯 ,预后差 ,其诊断及鉴别诊断有赖于特征性组织形态学及免疫表型特点

Nasal NK/T-cell lymphoma with cutaneous involvement: a clinicopathologic and immunohistochemical study

Objective To explore the clinicopathological and immunohistochemical features of nasal NK/T-cell lymphoma with cutaneous involvement. Methods 3 cases of NK/T-cell lymphoma in nasal cavity with cutaneous involvement were analyzed by morphological examination and immunohistochemical staining. Results 3 patients presented with secondary cutaneous diseases in several months after diagnosis of nasal NK/T-cell lymphoma, and then died within one year. Both lesions of skin and nasal cavity shared common morphologic features, and their immuno-phenotypes were coincident with that of extranodal nasal type NK/T-cell lymphoma. Tumor cells were positive for LCA, CD56, TIA-1, cytoplasmic CD3 and CD2 , and negative for surface CD3 . Immunostaining showed that some tumor cells were also EBV positive in the 2 cases. The proliferative index of all the 3 cases were beyond 85% according to Ki-67 positive staining. Conclusions Nasal NK/T-cell lymphoma is a high-grade malignancy with obvious tendency to involve the skin and has poor prognosis. Its diagnosis and differential diagnosis may depend on characteristic morphology and immuno-phenotype.