课件：淋巴瘤讲义.ppt

Adult T-cell Lymphoma/Leukemia 高分化NHL（小淋巴细胞样） 低分化NHL（原始、幼稚淋巴细胞样瘤细胞） NHL血象（组织细胞型淋巴瘤细胞） Sezary Syndrome (CTCL) 皮肤 T-NHL (躯干部) 皮肤 T-NHL (Tumor Stage) Burkitt’s Lymphoma 复习思考题 何谓淋巴瘤？ 试述淋巴瘤的分类。 如何诊断淋巴瘤？ * Slide 5 Incidence refers to the number of newly diagnosed cases for a specific disease during a specific time period, usually a year. Prevalence refers to the number of cases at a particular time whether they decreased that year or in previous years. Non-Hodgkin lymphoma is the fifth most common form of cancer in the United States, with an estimated 314,400 people affected. The National Cancer Institute estimates there will be approximately 53,400 new cases and 23,400 deaths from non-Hodgkin lymphoma in the U.S. in 2001. Interest in non-Hodgkin lymphoma has increased in recent years because of the dramatic increase in the number of cases between the 1950’s and 1990’s. References: The Leukemia Lymphoma Society, Leukemia, Lymphoma, Myeloma, Facts, 2003. Ries LAG, et. al. SEER Cancer Statistics Review, 1975-2000: National Cancer Institute. Bethesda, MD. US Department of Health and Human Services: 2003. * Slide 6 Although lymphoma occurs at virtually all ages, over 95% of cases occur in adults. The risk of developing NHL increases throughout life, with the elderly at greatest risk. Non-Hodgkin lymphoma is more common in men than women. Caucasians are affected more often than African Americans or Asian Americans. References: The Leukemia Lymphoma Society, Leukemia, Lymphoma, Myeloma, Facts, 2003. * The abnormal lymphocytes have deeply lobulated nuclei, which sometimes is referred to as a flower or cluster leaf nucleus. Immunophenotypically, these are CD4+ lymphocytes. (Giemsa, Oil) 3. 病理分型（Rye分类） Rye会议分类 特点 预后 淋巴细胞 为主型 成熟淋巴细胞为主，RS细胞少 较好，平均存活4.2年 结节硬化型 RS细胞常巨大，在固定过程中往往胞浆收缩，使其周围呈裂隙样，称裂隙细胞 好，平均存活9.2年 混合细胞型 淋巴细胞、浆细胞、中性粒细胞、嗜酸粒细胞及中等量RS细胞混同存在 较差，平均存活2.5年，易转为其他组织恶性肿瘤 淋巴细胞 减少型 淋巴细胞少见，RS细胞大量增生或呈纤维硬结样 最差，1年左右 HD分型 注：REAL，欧美淋巴瘤分型法修订版 *：包括不可分型的病例 +：包括一些淋巴细胞和/或组