胃肠道间变性大细胞淋巴瘤临床病理观察  

Clincopathological observation of gastrointestinal anaplastic large cell lymphoma

作　　者：郭文若 陈一峰[2] 欧阳永娥[2] 黄幼玉 黄惠珍 

机构地区：[1]福建省南安市医院病理科,362300 [2]福建省泉州市第一医院病理科

出　　处：《白血病．淋巴瘤》2013年第12期732-735,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 探讨胃肠道间变性大细胞淋巴瘤（ALCL）的临床病理学特征、免疫组织化学表型特点.方法 对3例确诊为ALCL患者的临床表现、组织形态及免疫表型进行分析,并复习相关文献.结果 ALCL临床无特征性改变,病理学组织形态呈多形性,包括不等量的怪异核、马蹄铁或肾形核,其中1例以肉瘤样特征为主.免疫组织化学均表达LCA、CD3、CD4、CD5、CD45Ro、CD30; ALK（2／3）阳性表达;不表达B细胞相关抗原、CD15及肌源性、神经源性、上皮源性抗原.结论 ALCL是罕见的胃肠道淋巴造血系统肿瘤,无明确临床特征,恶性度高,常被误诊为癌或肉瘤,需要活组织检查及病理确诊.Objective To explore the clinicopathological features,immunohistochemical characteristics of gastrointestinal anaplastic large cell lymphoma （ALCL）.Methods Clinical manifestations,histology and immunophenotype of three cases diagnosed with gastrointestinal ALCL were analyzed with the review of related literatures.Results The clinical manifestations of gastrointestinal ALCL were of no characteristical changes.The pathological features were pleomorphic in which some bizarre,horseshoed or kidney-shaped nuclei were seen.The characteristic of one of the three cases was shown as sarcomatoid.All cases expressed LCA,CD3,CD4,CDs,CD45Ro,CD30,two out of three cases expressed ALK protein,otherwise they were negative for B cell related antigens,CD15 and muscle,nerve,epithelium originated antigens.Conclusions ALCL of the gastrointestinal tract is extremely rare as one of the lymphatic hematopoietic system tumors.No definite clinical characteristic is seen in the gastrointestinal ALCL with high grade malignancy.It is easily misdiagnosed as carcinomas or other sarcomas.It is necessary to use biopsy to make a pathological diagnosis.

关 键 词：淋巴瘤 大细胞 间变性 胃肠肿瘤 病理学 临床 免疫表型分型 

分 类 号：R733.1[医药卫生—肿瘤]