经典型霍奇金淋巴瘤累及骨髓的临床病理分析  

Bone marrow involvement of Hodgkin lymphoma: a clinicopathological analysis of four cases

作　　者：殷仁斌 刘玉霞 任伟丹 丁利霞 胡旭静 YIN Ren-bin;LIU Yu-xia;REN Wei-dan;DING Li-xia;HU Xu-jing(Department of Hematopathology/Pashology,Zhengzhou Kingmed Center Corporation for Clinical laboratory,Zhengzhou 450000,China)

机构地区：[1]郑州金域临床检验中心有限公司血液病理诊断中心病理科,郑州450000

出　　处：《诊断病理学杂志》2020年第10期702-705,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨经典型霍奇金淋巴瘤累及骨髓的临床病理特征、免疫表型、诊断及鉴别诊断。方法对4例(3例初诊,1例为治疗后复发)经典型霍奇金淋巴瘤患者进行骨髓活检、免疫组化染色并复习相关文献。结果肿瘤区域呈"块状"分布,即"大结节状"分布,其与正常造血组织边界清晰,表现为正常造血组织区域和肿瘤区域"共存"状态或者完全挤占造血组织;在组织细胞、浆细胞、嗜酸性粒细胞、T淋巴细胞背景中可见散在的大细胞,为HRS细胞,典型的诊断性的RS细胞少见;4例均伴网状纤维增生,MF-1级2例,MF-2级1例,MF-3级1例,但无骨硬化;2例有骨髓坏死,分别为I级、III级。免疫组化:CD30、CD15、Fascin、MuM-1、EBV、p53、Ki-67(+),PAX-5弱(+),ALK、CD3、CD20、TIA、EMA(-)。结论经典型霍奇金淋巴瘤累及骨髓临床较少见,诊断需结合病理组织学特点和免疫组化。Objective To explore the clinicopathological features,immunophenotype,diagnosis,and differential diagnosis of bone marrow involvement of Hodgkin lymphoma(HL).Method Four cases of HL were studied by microscopic observation of bone marrow biopsy,and immunohistochemical staining.The related literatures were reviewed.Results The pattern of bone marrow involvement of HL was patchy,or completely replaced the normal hematopoietic tissue.Variant Reed-Sternberg cells were always present,but not the typical Reed-Sternberg cells with small T-lymphocytes and variable numbers of histiocytes,plasma cells,and eosinophils infiltrated.Bone marrow fibrosis(MF)was found in all cases;namely,two cases were MF-1,one was MF-2 and one was MF-3,but no osteosclerosis.Bone marrow necrosis was found in 2 cases:a case was maisel-I,another was maisel-III.The tumor cells were positive for CD30,CD15,Fascin,MuM-1,P53,EB virus,and PAX-5 dim,while negative for ALK,CD3,CD20,TIA and EMA.Conclusions The bone marrow involvement of CHL is relatively rare.The correct diagnosis is based on clinicopathological features and immunophenotype.

关 键 词：经典型霍奇金淋巴瘤 免疫组化 CD30 骨髓活检 

分 类 号：R733.4[医药卫生—肿瘤]