肝脏炎性假瘤样滤泡树突状细胞肿瘤1例报告及文献复习  

Hepatic inflammatory pseudotumor-like follicular dendritic cell tumor:report of one case and review of literature

作　　者：安晓静[1] 张正祥[1] 石群立[1] 吴波[1] 马捷[1] 周航波[1] 马恒辉[1] 

机构地区：[1]南京大学医学院临床学院南京军区南京总医院病理科,江苏南京210002

出　　处：《诊断学理论与实践》2009年第1期63-66,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:探讨肝脏炎性假瘤样滤泡树突状细胞肿瘤(IPT-like FDCT)的临床病理学特征。方法:对1例肝脏IPT-like FDCT患者(40岁男性,无临床症状,体检时发现肝脏内有占位性病变)的肿瘤组织进行临床病理学、免疫组织化学及行EBV转录的核内小RNA(EBER)原位杂交分析。结果:肿瘤与周围组织间有明显界限,中央可见坏死和出血。炎性背景较突出,主要包含淋巴细胞和浆细胞及少量嗜酸性细胞、中性粒细胞。肿瘤细胞呈束状、席纹状排列,更多的是散在分布于炎细胞间;瘤细胞呈短梭形,胞质丰富,淡伊红染色,核呈梭形或卵圆形,具有异型性且呈空泡状,可见核仁。免疫表型示,瘤细胞表达CD21、CD35和簇蛋白(clusterin),EBER原位杂交阳性。手术切除肿瘤后随访3个月,患者未出现复发和转移。结论:IPT-like FDCT是一种罕见的低度恶性肿瘤,其诊断与鉴别诊断依赖于组织病理学检查及免疫组化标记。Objective To investigate the clinicopathologic characteristics of inflammatory pseudotumor-like follicular dendritic cell tumor （IPT-like FDCT）. Methods One case of hepatic IPT-like FDCT was reported and analyzed by histopathology, immunohistoehemistry and Epstein-Barr virus （EBV） encoded small RNA in situ hybridization, and related literatures were reviewed. The patient was a male, 40-year old, and the hepatic neoplasm was found on physical examination. No clinical symptoms were present. Results The tumor was well demarcated from surrounding parenchyma. The central portion of tumor showed hemorrhage and necrosis. The prominent characteristic was the admixture of lymphocytes, plasma ceils, a few eosinophil cells and spindle cells arranging in vague fascicles or storiform or dispersal arrays. The nuclei were elongated or oval in shape, with minute chromatin, and distinct, often central nucleoli. The nuclei were atypia. Immunohistochemically, the tumor cells were positive for CD21, CD35 and clusterin, and were also positive for EBV encoded RNA by in situ hybridization. The patient was followed-up for 3 months, without recurrence or metastasis. Conclusions IPT- like FDCT is a rare low-grade maglinant tumor. The diagnosis and differential diagnosis of IPT-like FDCT mainly relies on histopathology, immunohistochemistry and EBER in situ hybridization.

关 键 词：肝脏 炎性假瘤 炎性假瘤样滤泡树突状细胞肿瘤 免疫组化 原位杂交 

分 类 号：R735.7[医药卫生—肿瘤]