眼结膜黏膜相关淋巴组织边缘带B细胞淋巴瘤临床病理分析  

Clinical and pathological features of conjunctiva mucosa associated lymphoid tissue marginal zone B cell lymphoma

作　　者：居红格[1,2,3] 谢建兰[1] 郭新建[1,4] 李月红[1,5] 韦萍[1,6] 郑媛媛[1] 金妍[1] 周小鸽[1] 

机构地区：[1]首都医科大学附属北京友谊医院病理科,北京100050 [2]内蒙古包头医学院第一附属医院病理科,包头014010 [3]内蒙古包头医学院病理学教研室,包头014060 [4]青海医学院附属医院病理科,青海810001 [5]河北医科大学第二医院病理科,石家庄050000 [6]首都医科大学附属北京朝阳医院病理科,北京100020

出　　处：《临床与实验病理学杂志》2014年第8期840-843,共4页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的 探讨眼结膜黏膜相关淋巴组织边缘带B细胞淋巴瘤（marginal zone B cell lymphoma of mucosa-associated lymphoidtissue）（简称为MALT淋巴瘤）的临床病理特征、治疗及预后。方法 对15例眼结膜MALT淋巴瘤患者的临床病理资料进行回顾性分析及随访,复查和完善HE及免疫组化染色切片,4例进行Ig基因重排克隆性分析。结果 （1）15例患者中,男性5例,女性10例,中位年龄42岁,病史平均20个月。（2）病理形态：黏膜下大量密集淋巴样细胞弥漫浸润,并有模糊淋巴滤泡样结节。浸润细胞多为小～中等大小的淋巴样细胞及单核样B细胞。（3）免疫表型：浸润细胞CD20、CD79a、BCL-2均（＋）,CD3、CD5、CD10、Cyclin D1、TdT均（-）。（4）Ig基因克隆性分析：4例均呈单克隆。（5）随访：随访时间2～35个月,截止随访日期,所有患者均生存,且病变无复发。结论 眼结膜MALT淋巴瘤好发于中年女性,结膜红肿突起为主要特征,镜下以小细胞样边缘带B细胞为主,具有典型MALT淋巴瘤的免疫表型和惰性临床经过,预后良好。Purpose To explore the clinical and pathological features of the eye conjunctiva mucosa associated lymphoid tissue marginal zone B cell lymphoma （ MALT lymphoma）. Methods Clinical data of 15 cases of conjunctiva MALT lymphoma patients were retrospectively analyzed and follow-up. HE staining and the immunohistochemical staining sections were reviewed and gene clonal rearrangement analysis was performed in 4 cases of patients. Results In the 15 cases, 5 were male, 10 females, with median age of 42 years. Medical history was an average of 20 months. The pathological morphology showed a large number of dense lymphoid cells were diffusely infiltrated under mucosa and the fuzzy lymphoid follicles nodules formed. Infiltrating cells of small to medium sized were lymphoid cells and monocytoid B cells. The immunophenotyping showed that infiltrating cells expressed CD20, CD79a, and BCL-2, and did not express CD3, CDS, CDIO, Cyclin D1 and TdT. Ig gene clonal analysis showed that all 4 cases were monoclonal. The follow-up time was 2 months up to 35 months and the results showed that all patients were survival, and lesions did not recur. Conclusion Conjunctiva MALT lymphoma is mainly found in the middle-aged, with a female predominance. The main characteristics are conjunctival redness and swelling. Microscopically, it is mainly composed of small marginal zone B cell, with typical immunophenotype of MALT lymphoma, inert clinical processes and good prognosis.

关 键 词：眼结膜肿瘤 黏膜相关淋巴组织边缘带B细胞淋巴瘤 免疫组织化学 基因重排 

分 类 号：R739.7[医药卫生—肿瘤]