儿童Burkitt淋巴瘤的临床病理分析  

Clinicopathological analysis of Burkitt lymphoma in children

作　　者：张莹丽 李莹 杨会杰 ZHANG Yingli;LI Ying;YANG Huijie(Department of Pathology,Puyang Oilfield General Hospital,Henan Puyang 457001,China)

机构地区：[1]濮阳油田总医院病理科,河南濮阳457001

出　　处：《肿瘤基础与临床》2025年第1期24-28,共5页journal of basic and clinical oncology

摘　　要：目的探讨Burkitt淋巴瘤的临床病理特征、免疫组化表型、分子遗传学特征、鉴别诊断、治疗及预后。方法收集2015年1月至2023年12月濮阳油田总医院收治的4例Burkitt淋巴瘤患儿,回顾性分析其病理组织学特征、免疫组化结果、EB病毒检测结果、诊断与鉴别诊断要点,并学习分析相关文献。结果4例患儿,均为男性,年龄3~10岁,发生部位分别为2例颌骨、1例小肠、1例回盲部;镜下观察4例患儿组织学形态相似,均表现为弥漫一致的中等大小肿瘤细胞,肿瘤细胞呈镶嵌型排列,“星空现象”明显,可见较多核分裂相和核碎片。4例患儿B细胞相关抗原均呈弥漫强阳性,包括CD19、CD20、CD79α、PAX-5、CD10、BCL-6、CD43,不表达BCL-2,Ki-67增殖指数均在90%以上,C-MYC表达弥漫强阳性,其中2例P53呈突变型,而CD5、CD3、CyclinD1和TDT均呈阴性。结论Burkitt淋巴瘤是一种高度恶性的B细胞淋巴瘤,具有典型的组织学形态、免疫表型及分子病理学特征可以明确诊断。由于Burkitt淋巴瘤生长迅速,预后不佳,随着其标准化治疗方案发展与应用,早期发现与治疗对于改善Burkitt淋巴瘤预后具有重要意义。Objective To investigate the clinicopathological features,immunohistochemical phenotype,molecular genetic features,differential diagnosis,treatment and prognosis of Burkitt lymphoma.Methods Four patients with Burkitt lymphoma diagnosed in Puyang Oilfield General Hospital from January 2015 to December 2023 were collected.The histopathological features,immunohistochemical results,Epstein-Barr virus detection results,diagnosis and differential diagnosis points were retrospectively analyzed,and the relevant literature was studied and analyzed.Results All the 4 patients were male,aged 3-10 years old.The sites of occurrence were jaw(2 patients),small intestine(1 patient)and ileocecal region(1 patient).Microscopically,the four patients showed similar histological morphology,with diffuse and uniform medium-sized tumor cells,which were arranged in a Mosaic pattern,with obvious"star-like phenomenon",and more mitotic figures and nuclear debris.All the 4 patients were diffuse and strongly positive for B-cell related antigens,included CD19,CD20,CD79α,PAX-5,CD10,BCL-6,CD43,but not BCL-2.Ki-67 proliferation index was above 90%,and C-MYC expression was diffuse and strongly positive.Two patients showed mutant P53 expression,CD5,CD3,CyclinD1 and TDT were negative.Conclusion Burkitt lymphoma is a highly malignant B-cell lymphoma with typical histological morphology,immunophenotype and molecular pathological features that can be clearly diagnosed.Due to the rapid growth and poor prognosis of Burkitt lymphoma,with the development and application of standardized treatment regimens,early detection and treatment can improve the prognosis of Burkitt lymphoma.

关 键 词：BURKITT淋巴瘤 病理诊断 预后 早期诊断 

分 类 号：R733.31[医药卫生—肿瘤]