纵隔结节硬化型霍奇金淋巴瘤的临床病理分析  

Clinicopathological Analysis of Mediastinum Nodular Sclerosis Hodgkin Lymphoma

作　　者：唐熹[1] 陈易华[2] 范严严[2] 简燚[2] 

机构地区：[1]成都市第六人民医院病理科,成都610051 [2]成都军区总医院病理科

出　　处：《华西医学》2016年第11期1842-1845,共4页West China Medical Journal

摘　　要：目的探讨纵隔结节硬化型霍奇金淋巴瘤(NSHL)的临床病理学特征,提高对该疾病的认识。方法收集2003年-2012年纵隔NSHL手术切除3例患者的病历资料。对纵隔NSHL病理标本采用形态学、免疫表型、T细胞受体(TCR)γ和Ig H基因重排及EB病毒编码小RNA(EBER)原位杂交等方法进行检测和分析。结果纵隔NSHL的病理形态为胶原纤维显著增生成束状并分割淋巴组织形成多个结节,肿瘤细胞边界清楚、细胞质空亮,单核或多个小核仁,结节背景有炎细胞浸润;肿瘤细胞均表达CD15、CD30及PAX-5,部分肿瘤细胞表达CD20,均不表达间变性淋巴瘤激酶、CD45、细胞角蛋白、CD79α、S-100等标记,Ki-67(+,>40%);3例肿瘤细胞均无TCRγ、Ig H基因重排;EBER原位杂交均为阴性。结论纵隔可发生多种淋巴瘤,NSHL是其中一种,掌握其独特的病理形态学特点及免疫表型对该疾病的诊断、鉴别诊断及治疗非常重要。ObjectiveTo study the clinicopathological features of mediastinum nodular sclerosis Hodgkin lymphoma （NSHL） in order to improve the recognition of it. MethodsThe clinical data of 3 cases of mediastinum NSHL between 2003 and 2012 were collected. Then we analyzed the carcinoma pathologic samples by pathomorphology, immunophenotypic phenotype, related gene rearrangement and situ hybridization with EBER. ResultsThe pathomorphologic results showed that broad fibrotic bands subdivided the lymphoid parenchyma into large nodules, the tumoral cells had distinct boundary with empty cytoplasm and small-to-medium-sized nucleoli, and the nodules contained inflammatory cell components. The immunophenotypic phenotype of the tumoral cells were CD15, CD30, PAX-5 and CD20 partly, but anaplastic lymphoma kinase, CD45, cytokeratin, CD79α and S-100 were not expressed. T cell receptor γ and IgH gene were no rearranged, and EBER in situ hybridization was not detected. ConclusionVarious lymphomas occur in the mediastinum and mediastinum NSHL is just one of them. Mastering its distinctive pathomorphology and immunophenotypic phenotype is highly significant for diagnosis, differential diagnosis and treatment of the disease.

关 键 词：纵隔 结节硬化型霍奇金淋巴瘤 免疫表型 原位杂交 基因重排 诊断 鉴别 

分 类 号：R734.5[医药卫生—肿瘤]