浆母细胞淋巴瘤的临床病理特征的研究  

The clinicopathological features of plasmablstic lymphoma

作　　者：范国庆[1] 刘一雄[1] 文璐[2] 王映梅[1] 王璐[1] 张月华[1] 王哲[1] 闫庆国[1] 杨兰[2] 郭英[1] 

机构地区：[1]第四军医大学肿瘤生物学国家重点实验室 病理学与病理生理学教研室 西京医院病理科,陕西西安710032 [2]第四军医大学西京医院血液内科,陕西西安710032

出　　处：《现代肿瘤医学》2014年第11期2690-2694,共5页Journal of Modern Oncology

基　　金：国家自然科学基金项目(编号:81071951);陕西省自然科学基金项目(编号:2009JM4002-2)

摘　　要：目的:浆母细胞淋巴瘤是弥漫性大B细胞淋巴瘤的一个罕见亚类。我国对浆母细胞淋巴瘤的报道多为个案报道,缺乏对其共性的研究。为了探求我国浆母细胞淋巴瘤的临床病理特征,我们进行了本次研究。方法:对10例浆母细胞淋巴瘤进行临床资料分析,免疫组化法检测免疫表型,原位杂交法检测EB病毒感染情况,用原位荧光杂交法检测MYC基因的易位和扩增。结果:浆母细胞淋巴瘤多发生于结外器官,发现时即为临床晚期,生存期短;其发病和HIV感染或免疫抑制无明显相关性。其EB病毒感染率为50%。免疫组化结果不常具有B淋巴细胞标记,但生发中心后表型常为阳性。MYC易位发生率为10%,扩增的发生率为10%。结论:我国浆母细胞淋巴瘤多发生于免疫状态正常的患者。HIV感染鲜有阳性,EBV感染率略低,存在MYC基因异常但发生率较低(约20%),但其高度侵袭性的淋巴瘤的特性、病理形态特征、免疫表型和临床表现与西方报道相似。Objective：Plasmablastic lymphoma（PBL） is a rare sub-group of diffuse large B cell lymphoma occuring in the clinical setting of HIV/AIDS and latent Epstein-Barr virus（EBV）infections.Due to the rarity of this disease,the common features of PBL of Chinese patients are much less understood.In order to analyze the clinicopathological character of PBL in our country we designed the current study.Methods：Clinical analyze was made on 10 PBL cases.Immunophenotype was detected by immunostaining.EBV infection was detected by EBER hybridization in situ.MYC gene translocation and duplication were detected by fluorescence hybridization in situ.Results：PBL occurred mainly in extranodal organs.It showed an aggressive clinical course with short survival.It had no distinct correlation with HIV infection or immnodeficiency.The rate of EBV infection was 50%.The immunophenotype was characterized by lacking B cell markers but possessing plasmablastic markers.Ki-67 index was high.The rate of MYC gene translocation was 10% while MYC gene duplication was 10%.Conclusion：PBL mainly occured in immuno competent patients in our country.It had no distinct correlation with HIV infection or immunodeficiency.It had a lower EBV infection rate.MYC gene aberrations were detected but the positivity was low （20%）.The morphology,immunophenotype and aggressive clinical character of PBL are similar to that in western countries.

关 键 词：浆母细胞淋巴瘤 HIV病毒 EB病毒 MYC易位 间变性浆细胞瘤 

分 类 号：R733.73[医药卫生—肿瘤]