胃肠ALK阳性间变性大细胞淋巴瘤3例临床病理观察  

ALK positive anaplastic large cell lymphoma of gastrointestinal tract

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]南安市医院病理科,福建南安362300 [2]泉州市第一医院病理科,福建泉州36200

出　　处：《诊断病理学杂志》2014年第2期80-83,86,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨胃肠间变性大细胞淋巴瘤(ALCL)的临床病理学特征、免疫组化表型特点。方法对3例确诊的胃肠间变性大细胞淋巴瘤患者的临床表现、组织学形态及免疫表型进行分析,并复习相关文献。结果胃肠间变性大细胞淋巴瘤的临床无特征性改变,组织学形态呈多形性,包括不等量的怪异核、马蹄核或肾形核,其中1例以肉瘤样特征为主。免疫组化:3例瘤细胞LCA、CD3、CD4、CD5、CD45RO和CD30均(+),2例ALK(+),B细胞相关抗原、CD15、肌源性、神经源性、上皮源性抗原均(-)。结论间变性大细胞淋巴瘤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,常误诊为癌或肉瘤,需要活检及病理确诊。Objective To explore the clinicopathological features and immunohistochemical characteristics of gastrointestinal anaplastic large cell lymphoma （ALCL）.Methods Clinical manifestations,histology and immunophenotype of three cases of gastrointestinal ALCL were investigated with the review of related literature.Results The clinical manifestations of gastrointestinal ALCL were of no characteristic changes.The pathological features were pleomorphic in which some bizarre,horseshoed or kidney-shaped nuclei were seen.The characteristics of one of the three cases were shown as sarcomatoid.All of the cases expressed LCA,CD3,CD4,CD5,CD45RO,and CD30; ALK （2/3） expressed as positive.Otherwise they were negative for B cell related antigens,CD15,muscle,nerve,and epithelial antigens.Conclusions ALCL is extremely rare,as one of the lymphatic hematopoietic system tumors of the gastrointestinal tract.No definite clinical characteristics are seen in gastrointestinal ALCL with high grade malignancy.It is easily misdiagnosed as carcinomas and other sarcomas.It is necessary for a pathological diagnosis to take a biopsy.

关 键 词：胃肠间变性大细胞淋巴瘤 临床特征 病理特点 免疫组化 

分 类 号：R735[医药卫生—肿瘤]