原发性乳腺弥漫大B细胞淋巴瘤临床和病理特征  

The clinical and pathological characteristics of primary breast diffuse large B-cell lymphoma

作　　者：汪园园 杨喆[1] 邓元[1] 常红云 李晓锋[1] 张冠军[1] 刘希[1] WANG Yuanyuan;YANG Zhe;DENG Yuan;CHANG Hongyun;LI Xiaofeng;ZHANG Guanjun;LIU Xi(Department of Pathology,the First Affiliated Hospital of Xi..an Jiaotong University,Xi’an,Shaanxi,China,710061)

机构地区：[1]西安交通大学第一附属医院病理科,陕西西安710061

出　　处：《分子诊断与治疗杂志》2018年第5期295-300,共6页Journal of Molecular Diagnostics and Therapy

基　　金：陕西省国际科技合作与交流计划项目(2016KW-001;2015KW-030);陕西省科学技术研究发展计划项目(2015SF128)

摘　　要：目的探讨原发性乳腺弥漫大B细胞淋巴瘤(primary breast diffuse large B-cell lymphoma,PB-DLBCL)的临床病理特征和遗传学上MYC基因重排情况。方法回顾性分析西安交通大学第一附属医院收治的8例PB-DLBCL临床病理资料,术前均诊断为乳腺癌或炎症。肿瘤最大直径1.8～7.4 cm,平均3.3 cm,其中ⅠEA期5例,ⅡEA期2例,ⅣE期1例。行免疫组织化学染色进行免疫分型,采用原位杂交检测EBV感染状态,采用荧光原位杂交检测MYC重排情况。结果 PB-DLBCL的肿瘤细胞弥漫或略呈结节状浸润乳腺组织,可见残存的乳腺导管。肿瘤细胞呈中等-大的中心母或免疫母细胞样形态。根据Hans分型,非生发中心B细胞型7例(87.5%),生发中心B细胞型1例(12.5%)。8例病例EBER原位杂交均为阴性,无EBV感染。MYC荧光原位杂交检测显示无MYC重排或扩增。结论 PB-DLBCL临床表现难与乳腺癌、乳腺炎症区别,确诊需依靠病理组织学和免疫表型分析。PB-DLBCL免疫表型分型大部分为非生发中心型,目前研究尚未见PB-DLBCL中MYC重排阳性。Objective To investigate the clinicopathological characteristics and the genetic MYC gene rearrangement of primary breast diffuse large B-cell lymphoma(PB-DLBCL).Methods The retrospective analysis was performed for the clinical pathology data collected from 8 cases of PB-DLBCL who admitted to the First Affiliated Hospital of Xi--an Jiaotong University diagnosed with breast cancer or inflammation before surgery.The maximum diameter of the tumor ranges from 1.8 cm to 7.4 cm,with an average of 3.3 cm.There were 5 cases staged atⅠEA,2 atⅡEA,and 1 atⅣE.Immunophenotyping was performed by immunohistochemical staining.In situ hybridization was used to detect EBV infection status and MYC rearrangement.Results Tumor cells from PB-DLBCL were infiltrated into the breast tissues with a diffuse or slightly nodular pattern,and residual breast epithelium was present.The tumor cells were medium-large centroblastic-like or immunoblastic-like cytologic features.According to Hans classification,1 case was germinal center B-cell group(GCB)(12.5%),while 7 cases were non-GCB group(87.5%).EBER in situ hybridization was negative in 8 cases and no EBV infection.No MYC rearrangement or amplification were detected by in situ hybridization.Conclusions It is difficult to distinguish PB-DLBCL from breast cancer and inflammation only by clinical features.The accurate diagnosis depends on histopathology and immunophenotypic analysis.Most of PB-DLBCL are non-GCB group.Currently,no MYC rearrangement is found in PB-DLBCL.

关 键 词：乳腺 弥漫大B细胞淋巴瘤 临床病理 免疫表型 MYC基因重排 

分 类 号：R737.9[医药卫生—肿瘤]