原发性睾丸NK/T细胞淋巴瘤3例临床病理观察  

Primary NK/T cell lymphoma of the testis:clinical and pathological analyses

作　　者：钟鹏[1] 曾英[1] 马强[1] 林俐[1] 罗清雅[1] 肖华亮[1] 

机构地区：[1]第三军医大学第三附属医院野战外科研究所病理科,重庆400042

出　　处：《诊断病理学杂志》2017年第10期731-736,共6页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨原发性睾丸NK/T细胞淋巴瘤的临床病理特点、诊断与鉴别诊断及预后。方法收集3例原发性睾丸NK/T细胞淋巴瘤的临床资料,观察其组织学形态、免疫组化,并复习相关文献,探讨该肿瘤的病理诊断与鉴别诊断要点。结果 3例均为老年男性,发生于左、右及双侧睾丸各1例。镜下睾丸正常结构破坏,残余曲细精管间距离增宽,肿瘤细胞弥漫生长,可见明显的嗜血管现象;肿瘤细胞由小、中、大混合组成,核呈圆形、不规则形、杆状,胞质透亮或浅嗜酸性,核分裂象易见。免疫组化:瘤细胞CD2、胞质型CD3、CD43、CD45RO、CD56、TIA-1和perforin(+),CD57、CD20、CD79a、PLAP、CK、MPO、bcl-2和TDT(-)。原位杂交EBV编码RNA(+)。结论原发性睾丸NK/T细胞淋巴瘤罕见,病情进展快,预后差。结合组织学形态及免疫组化染色CD2、CD3和CD56及原位杂交EBV编码RNA检测有助于诊断。Objective To investigate clinicopathologic features and differential diagnosis of primary NK/T cell lymphoma of the testis.Methods The clinical and radiological data were collected in three cases of primary testicular NK/T cell lymphoma and their pathological and immunohistochemical features analyzed,and the pathological diagnosis and differential diagnosis were discussed based on related literature review.Results Three cases were old men,and the three lesions were located in the left,right testis and bilateral testes respectively.Histologically,the normal structure of testis was destructed,distance between residual seminiferous tube was broaden,tumor cells grown diffusely,and showed an angiodestructive growth pattern and infiltrated the vessel wall;tumor cells were composed by small,medium and large cells with round,irregular shaped,rod-shaped nucleus surrounded by clear or eosinophilic cytoplasm,with high mitoses.The neoplastic cells were positive for CD2,cytoplasmic CD3（CD3ε）,CD43,CD45 RO,CD56,Gr B,TIA-1,Perforin and EBER,while the expression of CD57,CD20,CD79 a,PLAP,CK,MPO,BCL-2 and TDT was negative.Conclusion Primary NK/T cell lymphoma of the testis is a rare entity and progresses rapidly,with a poor prognosis.The expression of CD2,CD3ε,CD56,Gr B and EBER play an important role in diagnosis.

关 键 词：NK/T细胞淋巴瘤 原发性 睾丸 EB病毒 

分 类 号：R733.1[医药卫生—肿瘤]