鼻腔NK/T细胞淋巴瘤临床病理特征及诊断分析  

Analysis of clinical and pathological features and diagnosis of nasal NK/T-cell lymphoma

作　　者：徐刚[1] 陈德忠[2] 王槐富[1] 何刚[1] 

机构地区：[1]四川省医学科学院.四川省人民医院耳鼻咽喉科,成都610072 [2]四川省人民医院病理科

出　　处：《实用肿瘤学杂志》2007年第2期114-117,共4页Practical Oncology Journal

摘　　要：目的探讨鼻腔NK/T细胞淋巴瘤的临床、病理特征,诊断和误诊原因。方法复习62例鼻腔NK/T细胞淋巴瘤的临床资料,应用组织病理学、免疫组化和原位杂交技术分析其临床特点、诊断、病理特征和免疫表型。结果鼻腔NK/T细胞淋巴瘤以鼻塞、涕血和头痛为主要症状,表现为面部中线破坏性病变。病理改变为肿瘤性淋巴样细胞弥漫或散在分布于凝固性坏死和多种炎细胞混合浸润的背景上。所有病例表达T细胞标记,不表达B细胞标记;NK细胞标记阳性5例;EB病毒mRNA阳性56例(90%)。结论鼻腔NK/T细胞淋巴瘤临床表现不典型,易误诊误治。免疫组化检查是确诊的重要方法。患者以T细胞为主,大多有EBV感染。Objective To discuss the clinical and pathological features,diagnosis and cause of misdiagnosis of the nasal NK/T- cell lymphoma.Methods The clinical data of 62 patients with nasal NK/T- cell lymphoma were reviewed about the clinical features and diagnosis. The formalin - fixed and paraffin - embedded biopsy specimens were analyzed by histopathology, immumohistochemistry and in situ hybridization. Results The main symptoms of nasal NK/T- cell lymphoma were nasal obstruction, epistaxis and headache, and presented with facial midline destructive lesion. The presentation of histopathology was that the neoplastic lymphoid cells scattered or diffused on the background of the coagulative necrosis and the multiple inflammatory cells. All cases were positively stained with T- cell marker, and negatively stained with B cell by immunohistochemistry. Five cases were positive for EBV-mRNA by in situ hybridization. Conclusion The clinical manifestation of nasal NK/T- cell lymphoma is not typical which is easy to be misdiagnosed and mistreated. The immunohistochemistry detection is an important method to diagnose. The T cell lymphoma is a major type of nasal NK/T- cell lym- phoma. It is associated with EBV infection.

关 键 词：鼻腔 淋巴瘤 NK/T细胞 免疫组化 EB病毒 

分 类 号：R739.6[医药卫生—肿瘤]