原发性纵隔大B细胞淋巴瘤临床病理分析并文献复习.PDFVIP

临床与病理杂志 2015, 35(5) J Clin Path ol R e s 849 doi: 10.3978/j.issn.2095-6959.2015.05.031 View this article at: /10.3978/j.issn.2095-6959.2015.05.031 原发性纵隔大B细胞淋巴瘤临床病理分析并文献复习 邵云，张博，张凤霞，崔淼，刘翠，许春伟，王怀涛，吴永芳，李晓兵 (军事医学科学院附属医院理科，北京 100071) [摘　要] 目的：探讨原发性纵隔大B 细胞淋巴瘤(primary mediastinal large B-cell lymphoma ，PMBL) 的临床病理 学特点及诊断要点。方法：收集2010年9月~2014年 12月病理确诊为PMBL 的病例，对其对PMBL进行 临床特点、病理形态学及免疫组织化学观察分析，并复习相关文献。结果：3例PMBL2例为男性， 1例为女性，3例均侵犯邻近器官，2例伴颈部或锁骨上淋巴结受累， 1例椎体受累 (C7-T4) 。镜下见 不同程度的纤维化，瘤细胞呈巢状或弥漫浸润，瘤细胞胞质空亮丰富，细胞核圆形或卵圆形，其中 1例可见坏死。免疫组织化学均表达CD20 、CD79a 、CD23 、bcl2 、CD23 ，其中2例表达CD30 ，均不 表达CD3 、CD5 。随访3例均生存，化疗后 1例获得CR ，2例获得PR 。结论：纵隔原发弥漫大B 细胞淋 巴瘤很少见，形态变化多端，容易引起误诊。提高对PMBL 的认识，对避免误诊是至关重要的。 [关键词] 纵隔大B 细胞性淋巴瘤；诊断；鉴别诊断；免疫组织化学 Clinicopathologic analyses of primary mediastinal large B-cell lymphoma and review of the literature SHAO Yun, ZHANG Bo, ZHANG Fengxia, CUI Miao, LIU Cui, XU Chunwei, WANG Huaitao, WU Yongfang, LI Xiaobing (Department of Pathology, Affiliated Hospital of Academy of Military Medical Sciences, Beijing 100071, China) Abstract Objective: To explore the characteristics of clinicopathology and diagnostic criteria about primary mediastinal large B-cell lymphoma (PMBL). Methods: The clinical features, histological and immunohistochemical features of these cases were analyzed, the related literatures were reviewed. Results: Of the 3 patients with PMBL, two were males and one was female. In all the cases adjacent organs were invaded. Cervical or supraclavicular lymph node were involved in two cases, while vertebral were involved in one case. Histologically the neoplasm cell