式细胞术在淋巴增殖性疾病中应用.ppt

肝穿活检确诊肝脾γδT细胞淋巴瘤 CD4+CD8+ neoplasms CD4+CD8+ is unusual in mature, but in T-ALL T-PLL CD3+CD2+CD5+, lacks CD34,CD10,TdT. T-PLL vs T-ALL 形态，临床特点 Inv（14），t（14；14）。 Rare cases ATLL , LGL and PTCL,U. CD4-CD8-neoplasms（1） EATCL; HSTCL Non-hepotosplenic γδ T cell lymphoma PTCL,U. NK/T, nasal type with a T cell rather NK-cell phenotype. CD4-CD8-neoplasms（2） EATCL: CD4-CD8-CD5- CD3+CD7+ TIA-1+GranB+perforin+ CD103+ Can be CD56+/- May be CD30+. FISH: 9q33-34. 病理改变依据 CD4-CD8-neoplasms（3） HSTCL CD4-CD8-CD5- CD56+ Variable CD16. Most CD57- Non-activated TIA-1+,but GranB-perforin-. Mary are TCRγδ, some TCRαβ. Isochromosome 7q. CD4-CD8-neoplasms（4） Non-hepatosplenic γδ T lymphoma Similar with HSTCL, but active cytotoxic phenotype. CD4-CD8-CD2+CD3+CD5-CD56+CD57- TIA-1+GranB+perforin+. Aggressive course. CD4-CD8-neoplasms（5） Extranodal T/NK lymphoma, nasal type. Most are NK cell, rather than T, CD56+CD3- Those with T and CD56+,should be included . Mature NK cell neuplasms Extranodal T/NK cell lymphoma, nasal type 生长部位；tissue based CD4-CD8-CD3s-CD5-CD7+CD56+ EBV+TIA-1+ GranB+perforin+ Aggressive NK cell leukemia 依赖临床与上述区别。 BM involve, a few circulating, 全身症状 LGL, subset. A more indolent Often CD57+EBV- Indispensable:必不可少的，必须的。 Some B cell lack surface immunoglobulin, including lymphoblasts, plasma cells, thymic B-cell and their neoplastic comterparts; acute lymphoblastic leukemia ALL , PCN, and primary mediastinal B-cell lymphoma respectively. CD5 aberrant: caution for small population of normal CD5 positive B cells exist. Non- neoplastic CD5+ B cells are found most often in the PB but may also be seen in lymph node specimens, especially in patients with autoimmune disease. Also, CD5+ can be found in a subset of nomal bone marrow B-cell precursors hematogones . * 必须与正常γδT鉴别 可以出现CD5,CD2缺失, CD3bright * EATCL：小肠相关T细胞淋巴瘤 Clinical information is more important in classification of T/NK than B * Abn. T（arrow）slightly downexpress CD5,and slightly larger than normal T cell. * Diagnos