脾边缘区淋巴瘤一例随访16年并文献复习  

Splenic marginal zone lymphoma： a case report and literature review

作　　者：王翠芝[1] 冯向东[1] 罗静[1] 史斌[2] 

机构地区：[1]首都医科大学附属复兴医院病理科,北京100038 [2]首都医科大学附属复兴医院血液科,北京100038

出　　处：《白血病．淋巴瘤》2009年第3期146-148,共3页Journal of Leukemia & Lymphoma

摘　　要：目的探讨脾边缘区淋巴瘤（SMZL）的临床及病理学特征、诊断、治疗及预后。方法详细报道1例随访16年的SMZL患者的临床表现、治疗效果及肿瘤原发灶和转移灶的组织形态学特点，并复习相关文献。结果SMZL临床以脾大为特征，常累及脾门淋巴结、外周血及骨髓，可发生结内及结外转移。形态学上肿瘤细胞小到中等大小，染色质较疏松，免疫组织化学肿瘤细胞sIgM（＋）、CD20^＋、CD79a^＋和bcl-2（＋）；CD3^-、CD5^-、CD10^-、CD21^-、CD43^-和CyclinD1（-）。结论SMZL是一种少见的原发于脾脏的低度恶性B细胞淋巴瘤，起病潜隐，进展缓慢，但可向大B细胞淋巴瘤转化。脾切除和化疗有一定疗效，但不易治愈。Objective To study the clinical and pathologic features, diagnosis, treatment and prognosis of splenic marginal zone lymphoma （SMZL）. Methods We reported the detailed clinical and pathologic presentation of a patient with SMZL, and monitored fellow-up to 16 years. Results Patients present with splenomegaly. SMZL usually involve bone marrow, peripheral blood and hilar splenic lympha nodes. Peripheral lymph nodes and nonhematolymphoid organs can be involved as well, but to a lesser extent. Microscopically, tumor cells are small to medium in size, with dispersed chromation. Tumor cells are sIgM（＋）, CD20^＋, CD79^＋, bcl-2（＋）, CD3^-, CD5^-, CD10^-, CD23^- and CyclinD1（-）. Conclusion SMZL is a rare low-grade B-cell lymphoma with an indolent clinical course. Splenectomy and chemotherapy are effective treatment but SMZL cannot be completelv cured and may transform to large B-cell lvmphoma at last.

关 键 词：淋巴瘤 脾 病理学 临床 免疫组织化学 治疗 预后 

分 类 号：R733[医药卫生—肿瘤]