皮肤结外鼻型血管内NK/T细胞淋巴瘤临床病理探讨  

Clinicopathologic features of skin extranodal intravascular NK/T-cell lymphoma,nasal type

作　　者：张立英[1] 皋岚湘[1] 王文岭[2] 

机构地区：[1]北京军区总医院病理科,北京100700 [2]北京军区总医院皮肤科,北京100700

出　　处：《诊断病理学杂志》2014年第10期609-613,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨皮肤结外鼻型血管内NK/T细胞淋巴瘤的临床病理特征、诊断和鉴别诊断、治疗及预后。方法回顾性分析1例皮肤结外鼻型血管内NK/T细胞淋巴瘤患者的临床资料、组织病理形态、免疫组化染色及原位杂交染色。结果光镜下皮肤附属器周围、血管周围和血管内可见中等大小的异型淋巴样细胞,肿瘤细胞胞质比较丰富、淡染,细胞核圆形、卵圆形或不规则,染色质深染,部分血管内可见纤维素样渗出物。免疫组化显示肿瘤细胞CD3和粒酶B(+),CD56部分(+),CD5和CD8散在(+),CD4、CD20和MPO(-);CD31显示大部分肿瘤细胞位于血管内;Ki-67阳性率>50%。EBER分子原位杂交(+)。结论皮肤结外鼻型血管内NK/T细胞淋巴瘤是一种罕见的血管内淋巴瘤,临床和病理均易与皮肤血管炎性病变混淆,因此掌握其临床病理特征对该病的诊断和鉴别诊断具有重要意义。Objective To investigate the clinical and pathological features,diagnosis and differential diagnosis,treatment and prognosis of skin extranodal intravascular NK/T-cell lymphoma,nasal type.Methods Retrospective analysis of the clinical data was conducted in one case of skin extranodal intravascular NK/T-cell lymphoma,nasal type,and the histopathological morphology,immunohistochemical staining and in situ hybridization staining were performed.Results Under light microscope,medium-sized atypical lymphoid cells were observed in the vascular volume,some of the neoplastic cells were surrounding the skin appendages and the vascular wall.The neoplastic cells had abundant light pink cytoplasm,the nuclei were round,oval or irregular with deep stained chromatin,fibrinoid exudates were visible in some of the cavity of the vessel.lmmunohistochemical staining showed that the neoplastic cells were positive for CD3,CD56 and granzyme B,CD5 and CD8,but negative for CD4,CD20,and MPO.CD31 staining showed that the majority of neoplastic cells were located within the vessels,Ki-67-positive rate was more than 50％.EBER in situ hybridization showed that some of the nuclei were positive.Conclusion Skin extranodal intravascular NK/T-cell lymphoma,nasal type,is a rare type of intravascular lymphoma.It is prone to be confused with skin inflammatory lesions,therefore,grasping the clinical and pathological features of skin extranodal intravascular NK/T-cell lymphoma,nasal type,will play an important role in the diagnosis and differcntial diagnosis of this disease.

关 键 词：结外鼻型NK/T细胞淋巴瘤 鼻型 血管内淋巴瘤 皮肤 病理诊断 

分 类 号：R733.1[医药卫生—肿瘤]