乳腺原发性弥漫性大B细胞淋巴瘤临床病理及免疫组化研究

目的探讨乳腺原发性弥漫性大B细胞淋巴瘤的免疫组化亚群分类及临床分期与预后的关系。方法收集6例乳腺原发性弥漫性大B细胞淋巴瘤的临床表现、病理学特点及免疫组化亚群分类进行了回顾性分析。结果 6例均为女性,年龄28～68岁,病变部位包括右侧乳腺4例,左侧乳腺1例,双侧乳腺1例。免疫组化分型均为非霍奇金淋巴瘤（NHL）中的弥漫性大B细胞淋巴瘤（DLBCL）,根据Hans免疫组化亚群分类,其中4例为非生发中心B细胞（非GCB）样型,2例为生发中心B细胞（GCB）样型。结论乳腺原发性恶性淋巴瘤中的弥漫性大B细胞性淋巴瘤的预后与免疫组化亚群及临床分期相关,非生发中心B细胞样型预后差,生发中心B细胞样型预后要好于非生发中心B细胞样型。临床分期越高预后越差。

Clinicopathologic Analysis and Immunohistochemical Study on Primary Breast Diffuse Large B-cell Lymphoma

Objective To study the immunohistochemical subtypes and the relationship between clinical stage and prognosis of primary breast diffuse large B-cell lymphoma（DLBCL）.Methods The clinical manifestations,pathological features and immunohistochemical subtypes of six cases of primary breast diffuse large B-cell lymphomas were analyzed retrospectively.Results Six female patients,whose age ranged from 28 to 68 years,included four patients in right breast,one patient in left,and one patient in bilateral breast.Immunohistochemical classification showed that six（100%） patients had diffuse large B cell lymphoma（DLBCL） of non-Hodgkin＇s lymphoma（NHL）.According to classification of immunohistochemistry subsets of Hans,four patients had non-germinal center B cell-like type（non-GCB）,two patients had germinal center B cell-like type（GCB）.Conclusion The prognosis of breast diffuse large B-cell lymphoma of primary malignant lymphoma is related to immunohistochemical subtypes and clinical stage.Non-germinal center B cell-like type has poor prognosis,and germinal center B cell-like type has better prognosis than non-germinal center B cell-like type.The higher clinical stage has the worse prognosis.