间变性淋巴瘤激酶阳性的大B细胞淋巴瘤病理形态学及分子遗传学研究  

Pathologic and molecular genetic study of anaplastic lymphoma kinase-positive large B-celllymphoma

作　　者：黄榕芳[1] 陈刚[1] 宫丽平[2] 陆俐丽[1] 

机构地区：[1]福建省肿瘤医院病理科,福州350014 [2]首都医科大学病理学系

出　　处：《中华病理学杂志》2011年第3期169-172,共4页Chinese Journal of Pathology

摘　　要：目的探讨问变性淋巴瘤激酶（ALK）阳性的大B细胞淋巴瘤的临床病理及分子遗传学特点。方法对3例ALK阳性的大B细胞淋巴瘤进行光镜观察，采用免疫组织化学EliVision法及分子遗传学方法检测，并结合文献进行分析和讨论。结果3例患者均为成年男性，年龄32～42岁，平均年龄36．3岁，病变累及淋巴结。镜下观察：淋巴结结构破坏，可见淋巴窦侵犯，肿瘤细胞大，呈免疫母细胞样／浆母细胞样形态。免疫组织化学示肿瘤细胞CD45、CD138、上皮细胞膜抗原、ALK阳性，且ALK蛋白染色呈胞质内颗粒状阳性，CD3、CD20、CD79a和CD30均阴性。3例间期荧光原位杂交均检测到ALK基因易位。结论ALK阳性大B细胞淋巴瘤是弥漫性大B细胞淋巴瘤的少见独立亚型，好发于中年男性，病变部位以淋巴结多见，具有特征性形态学、免疫表型和分子遗传学特点。Objective To study clinicopathologic and genetic features of anaplastic lymphoma kinase （ALK）-positive large B-cell lymphoma （LBCL）. Methods Light microscopy, EliVision immunohistoeheimical method and fluorescence in-situ hybridization were used to evaluate three ALK ＋ LBCL cases recently diagnosed accompanied with a literature review. Results All three cases were male adult patients （ mean age = 36.3 years ） with nodal involvement by lymphoma. Histologic evaluation revealed a diffuse effacement of the nodal architecture by the infiltration of tumor ceils. Sinusoidal infihration was seen. The neoplastic cells were large and exhibited the immunoblastic/plasmablastic morphology. By immunohistochemistry, all the cases showed a cytoplasmic granular staining of ALK. They were positive for CD45, CD138, and epithelial membrane antigen （EMA） , but were negative for CD3, CD20, CD79a and CD30. Fluorescence in situ hybridization （FISH） demonstrated the presence of ALK gene translocation in all of the cases. Conclusions ALK ＋ LBCL represents a distinct variant of diffuse large B-cell lymphoma, usually involving lymph node of middle-aged men. The tumor has a immunoblastic/plasmablastic morphology along with a distinct immunophenotypic profile and ALK gene rearrangement.

关 键 词：淋巴瘤 B细胞 免疫表型分型 原位杂交 荧光 诊断 鉴别 

分 类 号：R733.1[医药卫生—肿瘤]