EBV阳性的原发性中枢神经系统弥漫性大B细胞性淋巴瘤临床病理观察  

Epstein-Barr virus positive primary central nervous system diffuse large B-cell lymphoma: a clinicopathological analysis

作　　者：官兵[1] 李晓红 张桃华[1] 陈玲玲[1] 朱绚丽[1] 洪玉萍[1] 杨海生[1] 陆欢[1] 

机构地区：[1]上海市第六人民医院金山分院病理科,上海201599

出　　处：《诊断病理学杂志》2016年第4期263-266,共4页Chinese Journal of Diagnostic Pathology

基　　金：上海市科学技术委员会医学引导类科技项目(项目编号:134119b2800);上海市金山区卫生计生委面上项目(项目编号:JSKJ-KTMS-2014-14)

摘　　要：目的探讨EBV阳性的原发性中枢神经系统弥漫性大B细胞性淋巴瘤(DLBCL)的病理诊断和临床病理特点。方法对1例EBV阳性的中枢神经系统DLBCL的临床病理特点、免疫组化标记以及影像学特点进行详细分析,并结合相关文献进行复习。结果患者T1WI示低信号均质团块,T1WI增强示高信号均质团块,T2WI示等信号均质团块。肿瘤周围轻度水肿。肿瘤由大淋巴细胞构成,呈浸润性生长,肿瘤间质少,可见血管套袖结构,瘤细胞呈中心母细胞形态,可见数个小核仁,核分裂象易见。免疫组化肿瘤细胞LCA、CD20、CD79α、bcl-6和EBV(+),Ki-67约60%。结论 EBV阳性的原发性中枢神经系统DLBCL是罕见的恶性肿瘤,其预后较差;诊断需依靠MRI、病理、免疫组化等综合手段;化疗和放疗联合治疗可提高其生存期。Objective To study the clinicopathological characteristics of Epstein-Barr virus positive primary central nervous system diffuse large B-cell lymphoma. Methods A case of Epstein-Barr virus positive primary central nervous system diffuse large B-cell lymphoma was carefully analyzed by histopathology,immunohistochemistry and MRI. Results T1 WI was hypointense but T2 WI enhancement was hyperintense; T2 WI was isointense. Tumor cells were comparatively large and in diffuse infiltrative growth. The mesenchymal of tumor was very few,and perivascular cuffs were seen. The tumor cells showed centroblastic morphology, which had several small nucleoli, mitotic figures were easily visible.Immunohistochemical staining showed that the tumor cells are positive for LCA,CD20,CD79α,BCL-6,EBV and Ki-67（ about 60%）. Conclusion Epstein-Barr virus positive primary central nervous system diffuse large B-cell lymphoma is a rare malignant tumor which has poor prognosis, and its diagnosis depends on comprehensive histopathology,immunohistochemistry and MRI. The combination of chemotherapy and radiotherapy may improve its survival.

关 键 词：EB病毒 原发性中枢神经系统淋巴瘤 弥漫性大B细胞性淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]