卵巢原发性弥漫性大B细胞淋巴瘤临床病理观察_临床医学论文.docVIP

卵巢原发性弥漫性大B细胞淋巴瘤临床病理观察_临床医学论文 卵巢原发性弥漫性大B细胞淋巴瘤临床病理观察_临床医学论文 【摘要】 目的 探讨卵巢原发性弥漫性大B细胞淋巴瘤的临床病理特征及诊断、鉴别诊断要点。方法 对1例卵巢原发性弥漫性大B细胞淋巴瘤进行临床病理分析及免疫组化研究，并复习相关文献。结果 左侧卵巢完全被肿块取代，且对侧卵巢亦有侵及，大小7.0cm×5.0cm×4.5cm，呈实性、质细腻；镜下肿瘤组织具有相对一致的弥漫性大细胞组成，间以少量硬化性间质，肿瘤细胞表达LCA、CD20、CD79a、Vim，不表达CD45RO、CD3、CD30、CD56、NSE、CK、EMA、PLAP、CD117、β-HCG、CA125、AFP。结论 卵巢原发性弥漫性大B细胞淋巴瘤罕见，恶性度高，侵袭性强，形态上有弥漫分布的大细胞，组织形态学表现有较大差异，免疫组化在协助诊断上有决定性作用。 【关键词】 卵巢原发性弥漫性大B细胞淋巴瘤；组织病理学；免疫组化；诊断 Primary diffuse large B cell lymphoma of ovary:a clinicopathologic observation YANG Yu-lan.Department of Pathology,First TCM Hospital of Changde City,Changde 415000,China 【Abstract】 Objective To explore the clinical,histopathological features of primary diffuse large B cell lymphcma of ovary with emphasis on its differential diagnosis.Methods Clinical data and image findings were reviewed,and histopathologioal and immunohistochemistry changes were observed in a case of primary diffuse large B cell lymphoma of ovary.Results The left ovary,measuring 7.0cm×5.0cm×4.5cm,show itself parenchyma character,exquisite,completely replaced by tumor,and the oppostte ovary was also affected.Histologically,the tumor was characterzed by diffuse large cell and few sclerotic mesenchymal character.The tumor was positive for LCA,CD20,CD79a,Vim,and was regative for CD45RO,CD3,CD30,CD56,NSE,CK,EMA,PLAP,CD117,β-HCG,CA125,AFP.Conclusion Primary diffuse large B cell lymphoma of ovary is a rare,highly expressed and malignant neoplasm characterized by big cells widely expressed,The morphologic and immunohistochemistry is decisive for diagnosis. 【Key words】 primary diffuse large B cell lymphoma of ovary;histopathology;immunohistochemistry;diagnosis 在淋巴结外恶性淋巴瘤中原发于卵巢的淋巴瘤十分罕见［1，2］，而其中又以弥漫性大B细胞淋巴瘤属非霍奇金淋巴瘤中最多见、最复杂和最异质性的一组［3，4］，高度恶性。确保诊断的准确除依据常规HE染色下的组织形态学分析外，更有赖于免疫组化抗原、抗体特异性结合后的显色标记。本文报道1例卵巢原发性弥漫性大B细胞淋巴瘤，讨论其组织形态学及免疫组化染色特征，并复习有关文献。 1 资料与方法 1.1 一般资料 患者，女，31岁，腹痛2天，发现盆腔包块1天入院。妇查：左侧附件可扪及8.0cm×7.0cm×7.0cm大小包块，质硬，有压痛；右侧附件未扪及异常。阴道B超示：左侧附件可探及80mm×70mm大小的囊性包块，右侧附件可探及50mm×40mm大小包块。