乳腺原发性淋巴瘤临床病理观察  

Clinicopathological features of primary malignant lymphoma of breast

作　　者：李万军[1] 年瑞[1] 李维华[1] 方纪林 

机构地区：[1]西安交通大学医学院附属3201医院病理科,陕西汉中723000

出　　处：《诊断病理学杂志》2014年第2期101-103,共3页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨乳腺原发性淋巴瘤(PBL)的临床病理特征、免疫组化及鉴别诊断。方法回顾性分析2例乳腺原发性淋巴瘤的临床及病理资料,并辅以免疫组化分析。结果 2例均为女性,均因偶然发现乳腺无痛性包块就诊。镜下瘤细胞均匀一致,呈列兵状排列,洋葱皮样围绕乳腺小叶或导管,乳腺小叶和导管减少,间质纤维组织增生;瘤细胞圆形,胞质少,核尚规整,核分裂象易见。免疫组化:瘤细胞LCA、CD20和CD79a(+),PCNA、Ki-67阳性率均>30%,而CK广、vimentin、CD3、CD43、CD45RO、CD99、MPO、ER、PR、c-erbB-2均(-)。1例随访43个月后死亡,1例随访9个月,病情较稳定,仍在治疗中。结论乳腺原发性淋巴瘤罕见,预后差,组织学上需与乳腺浸润性小叶癌、乳腺粒细胞肉瘤、原始神经外胚层瘤、小细胞癌等鉴别。Objective To study the clinicopathological features,immunophenotypes and differential diagnosis of primary malignant lymphoma of breast.Methods The cilinical and pathological data of two cases were retrospectively analyzed,combined with immunohistochemistry.Results Two patients were all women,who presented with painless lumps in breast by accident were hospitalized.Histologically,tumor cells were uniform,both Indian-file arrangement,onion skin -like around the lobule or duct of mammary gland.Decrease of mammary lobules and ducts,and interstitial fibrous tissue proliferation were noted.The tumor cells were round,less cytoplasm,neat nuclear profile,and less mitosis.Immunohistochemically,tumor cells were positive for LCA,CD20,CD79a,and PCNA,but were negative for CK,vimentin,CD3,CD43,CD45RO,CD99,MPO,ER,PR,and CerbB-2,and Ki-67 index was all more than 30％.Follow-up data showed that one patient survived until now for 9 months,and another patient died after 43 months.Conclusion Primary malignant lymphoma of breast is a rare tumor and also has a poor prognoisis.Histologically,it should be distinguished from lobular carcinoma of breast,granulocytic sarcoma of breast,PNET and other small cells cancers.

关 键 词：乳腺 淋巴瘤 临床病理 免疫组化 

分 类 号：R737.9[医药卫生—肿瘤]