甲状腺血管内大B细胞淋巴瘤并文献复习  

Intravascular large B cell lymphoma of thyroid gland and review of literature

作　　者：陈佳梅 李文鹤[2] 刘杰 曾盼 谢永辉 章宏峰[2] 罗波[2] 

机构地区：[1]武汉大学人民医院肿瘤科,武汉430060 [2]华中科技大学同济医学院附属武汉市中心医院病理科,武汉430014

出　　处：《临床与实验病理学杂志》2018年第1期60-64,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨甲状腺血管内大B细胞淋巴瘤(intravascular large B-cell lymphoma,IVLBCL)的临床病理学特征。方法分析1例甲状腺IVLBCL的临床病理特征,并系统性复习我国1991~2017年文献报道的IVLBCL。结果甲状腺肿块病检示病损区小血管腔扩张,并充满大异型淋巴样细胞。免疫表型:淋巴样细胞CD20、Pax-5、BCL-2和MUM1均阳性,Ki-67增殖指数85%。结论 IVLBCL临床较罕见,无特殊性表现,易误、漏诊,明确诊断依靠病理检查。IVLBCL预后较差,早期诊断并及时接受有效化疗可延长患者生存期。Purpose To investigate the clinical-pathological characteristics of the primary thyroid intravascular large B- cell lymphoma （PT-IVLBCL）, Methods The clinical-pathological data of the PT-IVLBCL were analyzed retrospective. A comprehensive analysis of the literature on IVLBCL published between 1991-2017 in China were performed. Results A thyroid mass was identified in a physical examination of a 68-year- old male who initially presented with dyspnea accompanied by intermittent headache for about 1 month. Pathological results showed that large atypical lymphoma-like cells filled the small vessel capillaries in the lesion area. Immunohistochemical stai-ning revealed that the lymphoma-like cells were positive for CD20, Pax-5, BCL-2 and MUM1. The Ki-67 index was esti- mated to be approximately 85%. Conclusion IVLBCL is a rare and aggressive disease that is easy to be misdiagnosed or missed, because it＇s clinical presentations are non-specific. The correct diagnosis depends on pathology. IVLBCL is known for its rapid progression and poor prognosis, but timely diagnosis and treatment with chemotherapy can improve patients survival.

关 键 词：血管内淋巴瘤 大B细胞 甲状腺 结节性甲状腺肿 

分 类 号：R577[医药卫生—消化系统]