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时间:2019-05-24
《胃肠道原发性间变性大细胞淋巴瘤临床病理分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、I临床与实验病理学杂志JClinExpPathol2010Jun;26(3)·325·胃肠道原发性间变性大细胞淋巴瘤临床病理分析朱晓静,安晓静,马恒辉,吴波,石群立摘要:目的探讨胃肠道原发性间变性大细胞淋巴瘤(anaplasticlargecelllymphoma,ALCL)的病理形态、免疫表型特征及临床预后。方法对5例胃肠道原发ALCL进行形态观察,免疫组化标记及随访,并结合相关文献进行讨论。结果本组ALCL男女之比为1.5:1,平均年龄40.6岁。发生部位包括胃2例,胰、十二指肠1例,回盲部1例,结肠1例。所有病例均经外科手术切除,2例术后进行化疗。5例
2、中有4例随访3至12个月,其中1例死亡,3例健在。ALCL形态表现多样,细胞呈多形性,大小不等,胞质丰富,细胞核大而不规则,呈扭曲、肾形、马蹄形及花环状,甚至见多核及巨核瘤细胞。免疫表型:5例ALCL均阳性表达CD30,部分表达EMA、CD3和CD45RO,而不表达CKpan、CD20、HMB45、CD68、CD15和CD117。结论ALCL是一种少见的非霍奇金淋巴瘤,发生在胃肠道罕见,有必要与霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤、低分化腺癌、胃肠道上皮样间质瘤、恶性纤维组织细胞瘤等进行鉴别。关键词:胃肠道肿瘤;间变性大细胞淋巴瘤;免疫组织化学;鉴别诊断中图分
3、类号:R735;R733.41文献标识码:A文章编号:1001—7399(2010)03—0325—04ClinicopathologicalanalysisofprimarygastrOintestinalanaplasticlargecelllymphomaZHUXiao-jing,ANXiao-jing,MAHeng—hui,wuBo,SHIQun—li(DepartmentofPathology,NanjingGeneralHospitalofNanjingMilitaryCommand,Nanjing210002,China)Abstract:Pu
4、rposeToexplorethehistological,immunohistochemicalcharactersandprognosisofprimarygastrointestinalanaplasticlargecelllymphoma(ALCL).MethodsHistology,immunohistochemicalmarkersandfollow—upinformationoffiveprimarygastroin。testinalALCLcaseswereanalyzedandthecorrelatedliteraturewasreview
5、ed.ResetsTheALCLoffivepatientshad1.5:1male/fe—maleratiowithanaverageageof40.6(range,22~62years).2caseswerelocatedinthestomach,1inpancreasandduodenum,1inileocecaljunction,1incolon.Allpatientsunderwentoperationandtwopatientsreceivedchemotherapyaftersu~ery.Fourpatientsweresubjectedtof
6、ollow.upof3to12months,onediedandthreesurvived.ALCLshoweddistinctivemorphologicalcharacters.Thetumorsweremainlycomposedoflargeandpleomorphiccellswithabundantcytoplasm.Thenucleiwerelargeandiregularwithshapeoftwist,horseshoedandwreathlike.Multiplenucleiorhugenucleiwereseensometimes.Al
7、lfivecasesexpressedCD30andpartlyex—pressedCD3,EMAandCD45RO.AllfivecaseswerenegativeforCKpan,CD20,HMB45,CD68,CD15andCD117.ConclusionsPrimarygastrointestinalALCLisextremelyrare.ItisnecessarytodifferentiateitfromothertypeoftumorssuchasthediffuselargeBcelllymphoma,Hodgkinlymphoma,poord
8、ifferentiatedcarcinomas,ep
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