移植后淋巴增生性疾病六例临床病理分析  

Clinico-pathological analysis of 6 cases of post-transplant lymphoproliferative disorders

作　　者：王照明[1] 郑树森[2] 丁伟[1] 王丽君[1] 

机构地区：[1]浙江大学医学院第一附属医院病理科,杭州310003 [2]浙江大学医学院第一附属医院肝胆胰外科,杭州310003

出　　处：《中华血液学杂志》2007年第8期514-518,共5页Chinese Journal of Hematology

基　　金：浙江省医约卫生科学研究基金(2007B070)

摘　　要：目的观察移植后淋巴增生性疾病(PTLD)的临床及病理特征,提高其诊断水平。方法对6例 PTLD 患者进行苏小精-伊红染色和免疫组织化学 Envision 法染色、原位杂交及基因重排分析,并复习临床资料及随访结果。结果 6例中3例为同种异体肾移植后,诊断为单形性 PTLD,分别死于诊断后4、2及1个月。2例为同种异体肝移植后,1例诊断为单形性 PTLD,诊断后5个月死亡。1例诊断为早期病变。另1例是异休骨髓移植后诊断为多形性 PTLD,随访12个月病情较稳定,6例中4例检出 EBER1/2DNA。结论 PTLD 是发生于器官移植后的具有独特的病理形态和临床特征的淋巴增生性疾病,其预后与病理类型及临床分期相关。Objective To evaluate clinical and pathological features of post-transplant lymphoproliferative disorders（ PTLD ） and its significance in diagnosis. Methods Six cases of PTLD were studied by light microscope, immunohistochemistry, in-situ hybridization, and gene rearrangement analysis. The clinical and follow-up information were also reviewed. Results Among the 6 cases, 3 with monomorphic PTLD were renal transplant recipients, and died 4, 2, and 1 months after diagnosis. 2 were liver transplant recipients, 1 of whom with monomorphic PTLD died 5 months after diagnosis, the other one was diagnosed as early lesion of PTLD and the post-bone marrow transplant case was classified as polymorphic PTLD who survived for 12 months after diagnosis of PTLD. EBER 1/2 DNA was demonstrated in 4 cases. Conclusions PTLD is a lympboproliferative disease with distinctive morpbologic and clinical characteristics after organ transplantation. The prognosis of PTLD correlates with the pathological subtypes and clinical stage.

关 键 词：淋巴增生性疾病 移植 淋巴瘤 病理学 临床 

分 类 号：R55[医药卫生—血液循环系统疾病]