乳腺浸润性癌合并非霍奇金淋巴结内边缘区B细胞淋巴瘤6例临床病理分析  

Invasive breast carcinoma with B-cell lymphoma in the inner marginal zone of axillary lymph nodes:a clinicopathological analysis of six cases

作　　者：王续[1] 刘月平[1] WANG Xü;LIU Yue-ping(Department of Pathology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050010, China)

机构地区：[1]河北医科大学第四医院病理科,石家庄050010

出　　处：《临床与实验病理学杂志》2021年第9期1032-1037,共6页Chinese Journal of Clinical and Experimental Pathology

基　　金：河北省医学科学研究重点课题计划(20160653)。

摘　　要：目的探讨乳腺浸润性癌合并非霍奇金淋巴结内边缘区B细胞淋巴瘤(non-Hodgkin lymph node inner marginal zone B cell lymphoma,NHLNMZL)的临床病理特征、诊断及鉴别诊断。方法采用免疫组化MaxVision法对6例乳腺浸润性癌合并NHLNMZL进行检测,并行21基因检测及NHLNMZL的基因检测。结果6例均为乳腺浸润性癌合并NHLNMZL,其中1例浸润性微乳头状癌有2枚淋巴结发生转移。淋巴瘤免疫表型:CD20弥漫阳性,CD21示FDC网扩大但较细,BCL-2、MNDA阳性。乳腺浸润性癌基因检测:其中4例表现为中危(RS=26.69),1例表现为高危(RS=34.21),1例表现为低危(RS=12.34);NHLNMZL中IgH、IgK、IgL阳性,FISH检测BCL-2、BCL-6、MYC均无重组。结论乳腺浸润性癌合并NHLNMZL虽属于恶性,但其侵袭性和恶性级别均较低,应与淋巴造血系统肿瘤鉴别。Purpose To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of invasive breast carcinoma with B-cell lymphoma in the marginal zone of the axillary lymph nodes.Methods The immunohistochemical MaxVision method was used to detect 6 cases of invasive breast carcinoma with marginal zone B-cell lymphoma,and the 21 gene detection and the genetic detection of marginal zone B-cell lymphoma in the lymph node were performed.Results The 6 patients were all invasive breast carcinomas with B-cell lymphoma in the marginal zone of the lymph nodes.And 1 case of invasive micropapillary carcinoma had 2 lymph node metastases.Immunophenotyping of lymphoma showed that CD20 was diffusely positive.CD21 shows that the FDC network was enlarged but thin.BCL-2 and MNDA were positive.Breast invasive cancer gene detection showed that 4 cases were intermediate risk(RS=26.69),1 case was high risk(RS=34.21),1 case was low risk(RS=12.34).In marginal zone B lymphoma IgH,IgK and IgL were positive,and BCL-2,BCL-6,and MYC were detected by FISH without recombination.Conclusion Although invasive breast carcinoma with B-cell lymphoma in the inner margin of the lymph node is malignant,its aggressiveness and malignant grades are low.It should be differentiated from tumors of the lymphoid hematopoietic system to avoid missed diagnosis.

关 键 词：乳腺肿瘤 浸润性癌 边缘区B细胞淋巴瘤 21基因 

分 类 号：R737.9[医药卫生—肿瘤]