伴浆细胞分化的滤泡性淋巴瘤临床病理分析  

Follicular lymphoma with plasmacytic differentiation:a clinicopathologic analysis

作　　者：何杰[1] 郑声琴[1] 石群立[2] 姚青[1] 郭庆明[1] 魏晓莹[1] 王建华[1] 

机构地区：[1]东南大学附属中大医院病理科,南京210009 [2]南京军区南京总医院病理科,南京210000

出　　处：《临床与实验病理学杂志》2006年第3期287-291,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的分析伴浆细胞分化的滤泡性淋巴瘤(follicular lymphomas with plasmacytic differentiation,FLPD)的病理、免疫表型和细胞遗传学特点。方法利用HE染色、免疫组化和基因重排方法观察1例FLPD,并复习文献。结果光镜下肿瘤细胞呈大小不等的结节或滤泡样排列,部分区域弥漫分布。结节或滤泡部分由中心细胞和中心母细胞组成,其余大部分区域是由核偏位,胞质丰富的浆细胞或浆样细胞组成,核内包涵体(Dutcher小体)易见,胞质内包涵体(Russell小体)也可见。免疫组化:CD20,CD43,CD79α,CD138,bcl-6,bcl-2+,CD10-,CD30-,cyclin D1-,瘤细胞Ki-67增殖指数40%。IgH基因重排。随访15个月未见复发和转移。结论FLPD的免疫表型和细胞遗传特征同一般的FL,需与淋巴结反应性增生和其他类型淋巴瘤鉴别。Purpose To study the pathological, immounoprofile and cytogenetical features of follicular lymphomas with plasmacytic differentiation （FLPD）. Methods One case of follicular lymphomas （FL） was reported in which there were a large number of plasma cells. Immunohistochemistry and gene rearrangement studies were performed in the paraffin-embedded sections with review of histological changes and the related literature. Results Microscopically, the histological patterns of the tumor were nodular or follicular and partly diffuse. There were follicular center ceils and centroblasts in follicule. But mostly regions were composed of large amounts of plasmas ceils and plasmacytoid ceils. There were many Dutcher bodies in the nucleus, and some Russell body in plasmacytes. Immunohistochemically, the tumor ceils showed the expression of CD20, CD43, CD79α, CD138, bcl-6, and bcl-2. The proliferative index of Ki-67 was 40% in the tumor. The tumor showed rearrangement of IgH gene. The patient was followed-up for 15 months and no local recurrence and metastasis were found. Conclusions The pathological, immounoprofile and cytogenetical features of FLPD are similar to those of FL. This lesion should be taken into consideration in the differential diagnosis of reactive lymphoid hyperplasia and other lymphomas.

关 键 词：淋巴瘤 滤泡性 浆细胞 分化 免疫表型分型 

分 类 号：R733.4[医药卫生—肿瘤]