间变性大细胞淋巴瘤的临床病理和免疫组织化学分析  

A clinicopathological and immunohistochemical study on anaplastic large cell lymphoma

作　　者：金晓龙[1] 李采苹[1] 丁长囡[1] 储谦[1] 

机构地区：[1]上海第二医科大学附属瑞金医院病理科

出　　处：《中华病理学杂志》1999年第3期194-196,共3页Chinese Journal of Pathology

摘　　要：目的了解间变性大细胞淋巴瘤（ＡＬＣＬ）的临床病理特点、免疫表型和生物学行为。方法对８例ＡＬＣＬ进行临床病理和免疫组织化学ＡＢＣ法观察及随访６～２５个月。结果８例ＡＬＣＬ占同期淋巴瘤的４．１％。平均年龄４０岁，男性和女性各４例。皮肤型２例，全身型６例。临床分为Ⅰ期２例，Ⅱ期１例，Ⅲ期５例。组织学特点为肿瘤细胞高度异型，核分裂象多，并可有多种反应性细胞。免疫组化标记８例ＣＤ３０全阳性，ＣＤ１５全阴性；Ｔ细胞性５例，Ｂ细胞性３例。随访：皮肤型２例化疗缓解后分别生存了１４和２５个月；全身型３例生存了６～８个月。其余３例分别于确诊后第２天，第２０天和第１８个月死亡。结论ＡＬＣＬ是一组形态学相似，但临床表现和免疫表型多样的淋巴瘤，皮肤型恶性程度低，全身型ＡＬＣＬ属于高度恶性的淋巴瘤。Objective To study the clinicopathological characteristics, immunophenotype and biologic behavior of anaplastic large cell lymphoma (ALCL). Methods Clinicopathological and immunohistochemical methods (ABC method) were used to analyse 8 cases of ALCL and followed for 6 to 25 months. Results Eight ALCL patients (4 male and 4 female) accounted for 4.1% of the 195 lymphomas seen from 1994 to 1997. Average age was 40 years. Two tumors were located in the skin, the remainder were systemic. Clinical stage: stage , 2 cases; stage , 1 case; stage , 5 cases. Histopathology: Tumor cells exhibited high pleomorphism and a large amount of mitotic figures. Reactive components (cells) often observed in the background. Immunohistochemical studies found that all tumors reacted positively with CD30 and negatively with CD15. Five cases expressed Tcell's markers(CD3, UCHL1, CD43) and three expressed Bcell markers (CD79a, L26). After chemotherapy, two patients with cutaneous type ALCL had complete remission and survived 14 and 25 months respectively. Of the six systemic cases, three survived for 68 months, the remaining three died at 2 days, 20 days and 18 months after diagnosis. Conclusions This study found that ALCL was a group of lymphomas showing similarity in morphology but diversity in clinical presentation and immunophenotype. Even if the tumor is very responsive to chemotherapy, ALCL remains a high grade malignant lymphoma.

关 键 词：淋巴瘤 诊断 预后 病理 免疫组织化学 

分 类 号：R733.402[医药卫生—肿瘤]