侵犯骨髓的非霍奇金淋巴瘤41例病理诊断探讨  

Pathologic diagnosis of non-Hodgkin lymphoma with bone marrow involvement:an analysis of 41 cases

作　　者：刘恩彬[1] 陈辉树[1] 张培红[1] 李占琦[1] 孙琦[1] 杨晴英[1] 方立环[1] 孙福军[1] 

机构地区：[1]中国医学科学院北京协和医学院血液病医院病理科,天津300020

出　　处：《诊断病理学杂志》2011年第3期178-181,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的研究组织病理学在非霍奇金淋巴瘤(NHL)侵犯骨髓中的诊断价值。方法骨髓活检标本观察组织形态,流式细胞学(FC)、免疫组化(IHC)进行免疫表型分析。结果 41例确诊为NHL病例中,B细胞淋巴瘤27例,T细胞淋巴瘤14例。侵犯骨髓的NHL分型:弥漫型15例(36.59%),混合型11例(26.83%),间质型9例(21.95%),结节型5例(12.20%),窦内型1例(2.44%)。FC可对37例NHL(90.24%)分型,其余4例需结合病史及骨髓IHC结果确定。15例同时行IHC检测,其中12例明确分型,其余3例(2例SLL/CLL,1例HCL)需结合FC进一步分型。1例DLBCL经FC仍不能分型需结合IHC确定。结论骨髓病理组织形态、免疫表型在NHL侵犯骨髓的诊断方面具有重要价值,流式细胞学与免疫组化在免疫分型方面互为补充。Objective To explore the value of pathology at the diagnosis of non-Hodgkin lymphoma（NHL） involvement in the bone marrow.Methods Routine histologic examination was performed on bone marrow biopsies.Immunophenotype study was conducted on flow cytometric（FC） and immunohistochemical（IHC）methods.Results Among 41 NHLs,27 were B lymphomas and 14 were T types.The frequency of patterns of NHL bone marrow infiltration was as follow：diffuse（15/41,36.59%）,mixed（11/41,26.83%）,interstitial（9/41,21.95%）,nodular（5/41,12.20%）and intrasinusodial（1/41,2.44%）.Combined FC and IHC method,all of the 41 specimens could be immunophenotyped.37（37/41,90.24%） cases were immunophenotyped by FC alone,others based on extramedullary pathologic findings and bone marrow IHC result.12 of 15 cases could be phenotyped with IHC method,other 3（2 were SLL/CLL,and 1 HCL） cases should be combined with FC analysis.1 case of DLBCL could be phenotyped by IHC whereas FC could not.Conclusion Both bone marrow morphology and immunophenotype are of important significance at the diagnosis of NHL bone marrow involvement.FC and IHC are complementarity at immunophenotype.

关 键 词：非霍奇金淋巴瘤 骨髓病理学 免疫表型 诊断 

分 类 号：R733.1[医药卫生—肿瘤]