四川地区间变性大细胞淋巴瘤的临床病理与免疫组化研究  

A Clinicopathologic and Immunohistochemical Study of Anaplastic Large Cell Lymphoma in Sichuan

作　　者：李金范[1] 李甘地[1] 刘卫平[1] 李凤媛[1] 文锦[2] 郑敏[3] 王影[4] 

机构地区：[1]华西医科大学第一附属医院 [2]四川省人民医院病理科 [3]成都市第三人民医院病理科 [4]四川省肿瘤医院病理科

出　　处：《诊断病理学杂志》1999年第4期197-200,F002,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的观察四川地区间变性大细胞淋巴瘤（anaglasticlargecelllymphoma．ALCL）的临床病理和免疫组化特征。方法搜集临床资料并随访，应用免疫组化（ABC法），对19例ALCL的临床病理和免疫组化进行研究。结果19例ALCL均呈CD30强阳性，11例为T细胞性，4例为B细胞性，3例为Null细胞性，l例为杂合表达（T、B细胞标记均阳性）。11例为CD45阳性，10例EMA阳性，14例TIA1阳性。CD15及CD68均为阴性。形态学上瘤组织表现为窦、滤泡间侵犯，瘤细胞形态多样，可见胚胎样等瘤巨细胞，易与转移性低分化癌、霍奇金病、恶性组织细胞增生症等混淆。临床上ALCL多见于青年男性，有发热、消瘦、淋巴结肿大等症状。预后较差（2年生存率为45％）。结论本研究结果表明四川地区ALCL的临床病理和免疫组化特征与国外报道的一致，但预后较差。To investigate the clinicopathogic and immunohistochemical features of anaplastic large cell lymphoma(ALCL) in Sichuan. Methods Paraffin sections of l9 bioposies were investigaed with morphological and immunohistochemicalmethods.The clinical data of l9 patients were analyzed and all patients were followed-up. Results All l9 cases of ALCL re-vealed stuongly CD30 positivity,in which 11 expressed T-cell phenotype,4 B-cell Phenotype,3 neithe T-nor B-cell phenotype andone expressed hybrid form.There were ll cases with CD45, 10 with EMA and l4 with TLAl positive reactions, respectively. Noneexpressed CD15 or CD68. Distinctive morphologic features of ALCL were tumor cell pleomorphism, sinus and interfollicular infil-trates,as well as embryo-like giant cell. They could be misdiagnosed as metastasis of poorly-differentiated carcinoma,Hodgkin'sdisease,malignant histiocytosis,ect.Clinically,most patients with ALCL were young males with fever, weightloss and lym-phadenopathy,ect. The prognosis of patients with ALCL was bad (5 year survival was 45%). Conclusions These resultsshowed that the clinicopathologic and immunohistochemical features of ALCL in Sichuan were similar to other countries's but theirprognosis was worse.

关 键 词：淋巴瘤 大细胞间变性 临床病理 免疫表型 NHL 

分 类 号：R733.102[医药卫生—肿瘤]