慢性淋巴细胞性/桥本氏甲状腺炎合并甲状腺原发性淋巴瘤6例的临床病理学分析并文献复习  

Chronic lymphocyte/hashimoto's thyroiditis complicated with primary thyroid lymphoma:a clinicopathological analysis of six cases and review of literature

作　　者：董双双 田秀春 王翠梅 徐清 肖芹 顾学文 DONG Shuang-shuang;TIAN Xiu-chun;WANG Cui-mei;XU Qing;XIAO Qin;GU Xue-wen(Department of Pathology,Northern Jiangsu People's Hospital Affiliated to Yangzhou University/Clinical Medical College,Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学/临床医学院,江苏省苏北人民医院病理科,江苏扬州225000

出　　处：《诊断病理学杂志》2024年第7期614-618,共5页Chinese Journal of Diagnostic Pathology

基　　金：江苏省重点专科资金(ZDZKB0018);江苏省苏北人民医院科研重点基金项目资金(SBKY21004)。

摘　　要：目的探讨甲状腺慢性淋巴细胞性/桥本氏甲状腺炎合并淋巴瘤的临床病理特征。方法回顾性收集6例患者临床及病理学特征,随访并复习相关文献。结果6例患者,女性占5/6,患者年龄49~69岁,患者均存在甲状腺或颈部肿块病史,部分患者近期肿块增大,B超示甲状腺组织内不均质低回声。术后病理检查示弥漫大B细胞淋巴瘤,血管内大B细胞淋巴瘤,黏膜相关淋巴组织结外边缘区B细胞淋巴瘤,其中1例患者见乳头状癌。结论慢性淋巴细胞性/桥本氏甲状腺炎合并甲状腺原发性淋巴瘤罕见,好发于中老年女性,临床症状、影像学多无特征性改变,需结合临床、影像和病理特征进行诊断。Objective To investigate the clinicopathological features,immunophenotype,differential diagnosis and prognosis of chronic lymphocyte/Hashimoto's thyroiditis associated with lymphoma.Methods The clinical features and pathomorphology of 6 patients were reviewed,follow-up wae performed,and relevant literature was reviewed.Results Six patients(5 females),aged 49-69 years,had a history of thyroid/neck mass,some of which had been enlarged rapidly recently.B-ultrasonography showed heterogeneous hypoechoic lesions in the thyroid.Postoperative pathological examination showed that all 6 cases were B-cell lymphoma,including 3 cases of diffuse large B-cell lymphoma and 2 cases of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue,1 case of intravascular large B-cell lymphoma,of which 1 case was associated with thyroid papillary carcinoma.Conclusion Chronic lymphocyte/Hashimoto's thyroiditis associated with primary thyroid lymphoma is a rare disease.It usually occurs in middle-aged and elderly women,it is easy to miss or misdiagnose,and the final diagnosis needs the combination of clinical,imaging and pathology.

关 键 词：慢性淋巴细胞性/桥本氏甲状腺炎 甲状腺原发性淋巴瘤 临床病理学特征 免疫组织化学 

分 类 号：R736.1[医药卫生—肿瘤]