套细胞淋巴瘤的临床病理特征和细胞周期蛋白D1在诊断中的意义  

Clinicopathologic features of mantle cell lymphoma and the significance of cyclin D1 in diagnosis

作　　者：何小金[1] 李甘地[1] 刘卫平[1] 林友胜[1] 李俸媛[1] 廖殿英[1] 

机构地区：[1]四川大学华西医院病理科,成都610041

出　　处：《中华病理学杂志》2002年第4期300-304,共5页Chinese Journal of Pathology

基　　金：美国中华医学基金会 (CMB)基金资助项目 (0 0 72 2 )

摘　　要：目的　观察套细胞淋巴瘤的临床病理学特征及细胞周期蛋白D1染色在诊断中的意义。方法　对 8例淋巴结套细胞淋巴瘤作临床病理观察及随访 ,LSAB法做免疫表型分析 (CD4 5RO、CD5、CD2 0、细胞周期蛋白D1、Ki 6 7、bcl 2 )。结果　患者年龄 4 3～ 78岁 (平均年龄 5 7岁 ) ,男女 3∶1。组织学特点为 :(1)淋巴结结构破坏并被单一的淋巴样细胞所取代 ,淋巴细胞以套区增生性、结节性、弥漫性三种模式增生。 (2 )淋巴样细胞胞核有一定的不规则性 ,染色质中等致密 ,核分裂象少见 ,类似中心细胞。其中有 3例转变为高度侵袭性的母细胞样变型。所有的病例都呈cyclinD1与bcl 2阳性、CD2 0阳性、CD4 5RO阴性、CD5阳性。结论　套细胞淋巴瘤有其特征性的形态改变及免疫表型。根据组织病理学特征及cyclinD1阳性 ,可与其他类型的小B细胞淋巴瘤相鉴别。套细胞淋巴瘤的母细胞样变型也应当与其他变型区别。Objective To investigate the clinicopathologic features of mantle cell lymphoma (MCL) and the significance of immunostainning for cyclin D1 in diagnosis Methods Clinicopathologic observation and immunohistochemical stainning for CD20?CD45RO?cyclin D1?bcl 2?Ki 67?CD5 for 8 cases of mantle cell lymphoma were performed Results The 8 cases of mantle cell lymphoma consisted of 6 males and 2 females,aged from 43 to 78 years(mean 57 years) Histopathologically, MCL demonstrated architectural destruction by a vaguely nodular monomorphic lymphoid proliferation with vaguely nodular,diffuse or mantle zone growth patterns Analogous to centrocytes, the lymphoma cells with slightly to markedly irregular nuclear contours showed moderately dispersed chromatin and a low mitotic figure Three cases were transformed into highly aggressive blastoid variants The tumor cells were positive for CD20?CD5?bcl 2 and cyclinD1 in all 8 cases and negative for CD45RO Conclusions The clinicopathological features and special immunophenotypes were present in mantle cell lymphoma This tumor can be differentiated from other small B cell lymphomas on the basis of histopathologic features and positive cyclin D1 immunphenotype The blastoid variant should also be differentiated from other variants

关 键 词：套细胞淋巴瘤 细胞周期蛋白D1 诊断 病理 LSAB法 MCL 

分 类 号：R733.1[医药卫生—肿瘤]