散发性Burkitt淋巴瘤的病理学特点  

Clinical and pathological features of the sporadic Burkitt＇s lymphoma

作　　者：黄远洁[1] 刘翠苓[1] 宫丽平[2] 黄欣[1] 董格红[1] 时云飞[1] 张丹丹[2] 张婧[2] 周春菊[3] 张永红[4] 张燕[1] 高子芬[1] 

机构地区：[1]北京大学基础医学院病理学系,100191 [2]首都医科大学基础医学院病理学系 [3]首都医科大学附属北京儿童医病理科 [4]首都医科大学血液病中心

出　　处：《白血病．淋巴瘤》2009年第1期18-20,共3页Journal of Leukemia & Lymphoma

摘　　要：目的探讨散发性Burkitt淋巴瘤（BL）的临床病理、免疫表型及分子生物学特征。方法对20例散发性BL病例进行了光镜、免疫组化、EB病毒（EBV）原位杂交及间期荧光原位杂交（FISH）检测，结合临床特征进行综合分析。结果20例散发性BL中，男性16例，女性4例；年龄3—14岁，中位年龄9岁。光镜下部分典型的BL肿瘤细胞弥漫一致性增生浸润，见较明显的吞噬核碎片的巨噬细胞形成的“星天现象”。部分病例形态学需鉴别其他肿瘤。免疫组织化学染色显示，瘤细胞表达CD20和CD10不同程度地表达CD79a、bcl-6、MUM-1等，大于95％的瘤细胞Ki-67阳性；EBV原位杂交显示EBER 1／2阴性；间期FISH有c—myc基因异常。结论散发性BL属高度侵袭性淋巴瘤，需要与多种其他肿瘤鉴别，明确诊断有助于临床针对性地进行高强度治疗。基于分子水平及蛋白水平多项标志物的检测，可大大减少漏诊和误诊，并为临床的准确诊断和及时治疗提供有力的依据。Objective To investigate the clinical and pathological features of the sporadic Burkitt＇ s lymphoma （BL）, as well as its immunohistochemical and molecular characteristics. Methods 20 cases of sporadic BL were retrospectively studied by analyzing their light microscopy features, immunohistochemical expression, EBV infection detected by in stiu hybridization, chromosomal breakage of c-myc and/or IgH genes by interphase fluorescence in stiu hybridization （FISH）, and their clinical manifestation. Results All the 20 cases of sporadic BL occurred in children （3-14 y） including 16 males and 4 females. Microscopically, the medium-sized tumor cells were monomorphic and proliferated in a diffuse pattern showing ＂starry-sky＂ with numerous karyorrhectic debris. Mitotic figures were frequently seen. Immunohistochemically, the tumor cells were positive for CD20 and CD10, over 95 % positive for Ki-67 and negative for TdT, CD99, MPO. No EBV infection was found by in situ hybridization in 18 cases. Interphase FISH analysis detected c-myc gene breakage or amplification and/or IgH/c-myc gene breakage in all detected 15 cases. Conclusion Sporadic BL is a high-grade malignant B cell lymphoma. The tumor cell proliferation index is very high. Molecular and immunohistochemical analysis could reduce the incidence of misdiagnosis and thus plays a vital role on its correct diagnosis and appropriate therapy.

关 键 词：淋巴瘤 免疫组织化学 原位杂交 荧光 诊断 

分 类 号：R733[医药卫生—肿瘤]