鼻腔自然杀伤／T细胞淋巴瘤患者临床病理分析  

Clinicopathological analysis of the patients with natural killer/T cell lymphoma in nasal cavity

作　　者：丁志燕[1] 黄彩虹 杨家佳[1] 刘爽[1] 王正[1] Ding Zhiyan, Huang Caihong, Yang Jiajia, Liu Shuang, Wang Zheng(Department of Pathology, the Affiliated Hospital of Yangzhou University, Yangzhou 225009, Chin)

机构地区：[1]扬州大学附属医院病理科,225009

出　　处：《肿瘤研究与临床》2018年第3期193-196,共4页Cancer Research and Clinic

摘　　要：目的探讨鼻腔自然杀伤（NK）/T细胞淋巴瘤患者的临床病理特点、鉴别诊断及生物学特征。方法收集扬州大学附属医院病理科2007年9月至2017年7月17例鼻腔NK/T细胞淋巴瘤患者，总结其临床症状，观察病理形态改变及免疫表型，并结合文献分析。结果鼻腔NK/T细胞淋巴瘤患者临床症状起病隐匿，常因鼻塞、流涕、涕中带血等症状就诊。病理检查有明显的坏死和不同程度的炎症背景，炎症背景中可见异型的肿瘤性淋巴细胞，核呈不规则扭曲样或折叠样，核仁不明显，核分裂象可见，肿瘤细胞以血管为中心生长，可浸润和破坏血管，在上述的背景中可见形态正常的淋巴细胞、浆细胞及组织细胞等。肿瘤细胞表达CD3、CD43、CD56、TIA-1、粒酶B、穿孔素等标志物，EB病毒原位杂交阳性。结论鼻腔NK/T细胞淋巴瘤患者少见，临床呈高度侵袭性，复发率高，预后不良，容易误诊，需要借助免疫组织化学鉴别诊断。治疗以放、化疗为主。ObjectiveTo investigate the clinicopathological characteristics, differential diagnosis and biological features of natural killer （NK）/T cell lymphoma in nasal cavity.MethodsThe data of 17 cases of nasal NK/T-cell lymphoma from Department of Pathology in the Affiliated Hospital of Yangzhou University between September 2007 and July 2017 were collected. Pathologic analysis including clinical symptoms, pathomorphism and immunophenotyping was performed, and the literatures were also analyzed.ResultsThe clinical symptoms of the patients with nasal NK/T cell lymphoma were not obvious, which were accompanied by nasal congestion, runny nose, and blood in the runny nose. Pathologic examination showed obvious necrosis and inflammatory background of different levels. There were allotypic lymphocytes in the inflammatory background, nuclear irregular distortion or folding, unapparent nucleoli and visible nuclear fission, tumor cell growth for the center with blood vessels resulting in invasion and damage to blood vessels, in which normal lymphocytes, plasma cells and tissue cells could be seen. CD3, CD43, CD56, TIA-1, granzyme B, perforin and other markers were expressed in the tumor cells, and EB virus in situ hybridization was positive.ConclusionsNasal NK/T cell lymphoma is rare, with high incidence of invasive tumor, high recurrence rate, poor prognosis and easy misdiagnosis, which needs immunohistochemistry for differential diagnosis. Treatment is mainly based on radiotherapy and chemotherapy.

关 键 词：鼻腔肿瘤 淋巴瘤 结外NK/T细胞 免疫组织化学 

分 类 号：R739.62[医药卫生—肿瘤]