四例肠病型T细胞淋巴瘤的临床病理分析.docVIP

四例肠病型T细胞淋巴瘤的临床病理分析 　　摘要：目的：探讨肠病型T细胞淋巴瘤（enteropathy type T-cell lymphoma，ETCL）的临床和病理特征、免疫表型及鉴别诊断，并进行分析。方法：采用回顾性分析的方法对收集的2011年12月～2013年12月期间4例肠病型T细胞淋巴瘤患者的临床资料、病理检查及免疫组化表型进行分析。结果：4例患者中男性2例、女性2例；发生部位：小肠2例，结肠2例。病灶大体形态主要为溃疡型，还包含外生性、肠壁局部加厚。肿瘤细胞大小不等，多为中等偏小，细胞核表现为多形，有核仁，核分裂多见，伴炎性背景。免疫表型：CD3、CD43、CD45RO全部阳性表达，CD56部分表达，1例做了粒酶B表达，不表达CD79?、CD20、bcl-6、AE1/AE3、MUM-1，Ki-67阳性高表达。结论：肠病型T细胞淋巴瘤在临床上较少见，临床对其诊断应结合临床症状和相关病史，并主要依据病理检查及相关的免疫组化检查综合判断，避免漏诊、误诊的发生，尽早诊治有助于提高患者生存率。 　　关键词：肠病型T淋巴细胞瘤；免疫组化；鉴别诊断 　　Abstract：Objective： To investigate the enteropathy type T cell lymphoma （enteropathy type T-cell lymphoma， ETCL） of the clinical and pathologic features， immunophenotype and differential diagnosis， and carries on the analysis. Methods： a retrospective analysis of 2011 December ～2013 years collected during December 4 cases of enteropathy type T cell lymphoma in the clinical data， pathological examination and immunohistochemical phenotype analysis. Results： 2 cases in 4 patients， male 2 cases， female 2 cases； location： the small intestine， 2 cases of colon. Gross morphology is mainly ulcerative lesions， also contains the local thickening of exogenous， intestinal wall. The tumor cells vary in size and more for small to medium， the nucleus showed pleomorphic， a nucleolus， nuclear division to see， with inflammatory background. The immune phenotype： CD3， CD43， CD45RO were all positive expression， CD56 part of the expression， 1 cases did the granzyme B expression， no expression of CD79 alpha， CD20， bcl-6， AE1/AE3， MUM-1， Ki-67 expression. Conclusion： enteropathy type T cell lymphoma is rare in clinic， the clinical diagnosis should be combined with clinical symptoms and related history， and mainly based on pathological examination and the related immunohistochemical examination comprehensive judgment， to avoid missed diagnosis， misdiagnosis， early diagnosis is helpful to improve the survival rate of the patients. 　　keyword： enteropathy type T cell lymphoma； immunohistochemistry； differential