50例原发性消化道恶性淋巴瘤的病理研究

应用HE、甲基绿-派若宁(MGP)及免疫过氧化酶染色法(PAP)对50例原发性消化道恶性淋巴瘤进行了回顾性临床病理分析及免疫功能分类。研究发现消化道B淋巴瘤的比例偏高,预后亦较结内淋巴瘤为好。认为消化道淋巴组织可能为周围淋巴器官。在消化道淋巴瘤中观察到“淋巴上皮性病变”,有助于鉴别诊断消化道未分化癌。MGP染色与PAP染色的符合率达96.8%,两种染色方法作为诊断B淋巴瘤的指标同样可信。

PATHOLOGIC STUDY OF 50 CASES OF PRIMARY GASTROINTESTINAL LYMPHOMA

50 cases of primary gastrointestinal lymphoma were respectively studied using HE, MGP (methyl-green pyronine) and PAP (peroxidase antiperoxidase) methods in this article. The results showed that predominant histologic type in gastro-intestinal tract was follicular center cell type, but T cell lymphoma, histocyte lymphoma and Hodgkin' s disease were also observed Lymphoepithelial lesion was characteristic in digestive lymphoma. PAP marking of CIg demonstrsted that 22 cases of 31 B cell lymphoma were CIg positive (70.97%), 63.6% out of which was monoclonal type, 27.3% polyclonal. 23 cases (74.2%) showed MGP positive among 31 B-cell lymphoma patients, whereas 25.8% negative. The accordance rate of MGP and PAP method in B-cell lymphoma was as high as 96.8%. 2-year survival rate of diffuse type lymphoma at this series was 46.2%, 5-year survival was 37.2%. It is concluded that (1) B-cell lymphoma is of high percentage in digestive tract, and gastrointestinal lymphoma has a better prognosis. (2) various histogenesis of gastrointestinal lymphoma suggests that the lymphoid tissue of gastrointestinal tract may be a peripheral lymphoid organ. (3) "lymphoepithelial lesion" is useful in differentiating lymphoma from undifferentiated carcinoma in digestive tract. (4) as parameter of diagnosing B-cell lymphoma, MGP and CIg PAP methods are similarly reliable.