血管免疫母细胞淋巴结病样T细胞淋巴瘤1例动态临床病理观察  

Clinicopathological changes of angioimmunoblastic lymphadenopathy-like T-cell lymphoma:a case report with review of the literature

作　　者：庄严阵[1] 陈佩琼[1] 杨萌霓[1] 

机构地区：[1]福建医科大学附属厦门市第一医院病理科,厦门361003

出　　处：《临床与实验病理学杂志》2004年第1期74-78,共5页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的　探讨血管免疫母细胞淋巴结病样T细胞淋巴瘤 (AILD TCL)的临床病理学特点和鉴别诊断要点。方法　对 1例AILD TCL病程的不同时期进行临床病理学观察与免疫组织化学检测。结果　病变早期淋巴结表现为多形性细胞 (中、小淋巴细胞、嗜酸性细胞、浆细胞、免疫母细胞及组织细胞 )浸润伴分支状毛细血管后小静脉的明显增生而导致正常结构的部分破坏 ,细胞无明显异型。病变中期出现散在分布的胞质透明、紧密排列的免疫母细胞簇 ,细胞中度异型。病变后期 ,免疫母细胞成簇或弥漫分布 ,细胞异型性大 ,核分裂象易见。免疫组化标记示淋巴结内弥漫性浸润的细胞胞质表达CD3、CD4 5RO、CD4、CD8,增生的滤泡树突细胞表达CD2 1,CD2 3阳性的中心细胞稀少。结论　AILD TCL是一种发展快、预后差的周围T细胞淋巴瘤 。Purpose To study the clinicopathological feature and differential diagnosis of angioimmunoblastic lymphadenopathy like T cell lymphoma (AILD TCL). Methods One case of AIDL TCL was analyzed by light microscopy and immunohistochemistry. Results Microscopically, in early stage of the disease, lymph node architecture was partially effaced.The paracortex was diffusely infiltrated by a polymorphous population of small to medium sized lymphocytes, eosinophils,plasma cells,and histiocytes. High endothelial venules were abundant and showed arborization.The lymphocytes showed minimal cytologic atypia.In middle stage, the abnormal lymphoid cell clusters appeared with clear to pale cytoplasm and distinct cell membranes and showed medium degree cytologic atypia.In late stage, the cells were distributed all over the place and showed high degree of cytologic atypia.Immunophenotypically, these cells were positive for CD45RO, CD3, CD4, and CD8. The follicular dendritic cells (CD21+) were conspicuous and the follicular central cells(CD23+) were deficient. Conclusion AILD TCL is a peripheral T cell lymphoma, which develops promptly with poor prognosis. Knowledge of the histopathologic features of the tumor is important to early diagnosis and treatment.

关 键 词：血管免疫母细胞淋巴结病样 T细胞淋巴瘤 动态分析 临床症状 病理观察 

分 类 号：R733.4[医药卫生—肿瘤] R551.2[医药卫生—临床医学]