梭形细胞变异型弥漫性大B细胞淋巴瘤1例报道及文献复习

目的：探讨梭形细胞变异型弥漫性大B细胞淋巴瘤的临床病理特征、病变性质及鉴别诊断要点。方法：对1例梭形细胞变异型弥漫性大B细胞淋巴瘤的组织形态特征、免疫组化表型，结合临床预后进行分析。结果：1例23岁女性患者在半年内先后发生结肠肿瘤和乳腺肿瘤。HE切片显示肿瘤细胞弥漫性浸润肠壁和乳腺组织，瘤细胞有异型性和核分裂，并伴有显著的梭形细胞特征。免疫表型显示瘤细胞CD45 ，CD20 ，CD45RO-，CD30-，Vim ，Des-，SMA-，S-100-，CK-，EMA-。患者1年内死于肿瘤。结论：本例梭形细胞变异型大B细胞淋巴瘤是一种罕见的高度恶性肿瘤，在缺乏免疫组化标记的情况下易误诊为肉瘤或低分化癌。

Diffuse Large B Cell Lymphoma with Spindle Cell Variant: Report of 1 Case and Review of the Literature

Objective: ?To investigate the clinical-pathological features,and differential diagnosis of diffuse large B cell lymphoma with spindle cell variant. Methods: ?A case of diffuse large B cell lymphoma with spindle cell variant was analyzed for histomorphology,immunohistochemical features and clinical prognosis. Results: ?One case of 23-year-old female presented sequentially colon tumor and breast tumor within a half year.Slides with HE staining showed that tumor cell infiltrated diffusely in colon and breast tissue and displaiyed atypia mitosis and spindle cell features.In immunopheaotype tumor cell showed CD45++,CD20++,CD45RO-,CD30-,Vim+,Des-,SMA-,S-100-,CK-,EMA-.Patient died of tumor within a year. Conclusion: ?The case of diffuse large B cell lymphoma with spindle cell variant is a rare high degree malignant tumor,it is likely to be misdiagnosed as sarcoma or low differential carcinoma without doing immunohistochemical marks. [