白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2009年
1期
18-20
,共3页
黄远洁%刘翠苓%宫丽平%黄欣%董格红%时云飞%张丹丹%张婧%周春菊%张永红%张燕%高子芬
黃遠潔%劉翠苓%宮麗平%黃訢%董格紅%時雲飛%張丹丹%張婧%週春菊%張永紅%張燕%高子芬
황원길%류취령%궁려평%황흔%동격홍%시운비%장단단%장청%주춘국%장영홍%장연%고자분
淋巴瘤%免疫组织化学%原位杂交,荧光%诊断
淋巴瘤%免疫組織化學%原位雜交,熒光%診斷
림파류%면역조직화학%원위잡교,형광%진단
Lymphoma%Immunohistochemistry%In situ hibridization,fluorescence%Diagnosis
目的 探讨散发性Burkitt淋巴瘤(BL)的临床病理、免疫表型及分子生物学特征.方法 对20例散发性BL病例进行了光镜、免疫组化、EB病毒(EBV)原位杂交及间期荧光原位杂交(FISH)检测,结合临床特征进行综合分析.结果 20例散发性BL中,男性16例,女性4例;年龄3-14岁,中位年龄9岁.光镜下部分典型的BL肿瘤细胞弥漫一致性增生浸润,见较明显的吞噬核碎片的巨噬细胞形成的"星天现象".部分病例形态学需鉴别其他肿瘤.免疫组织化学染色显示,瘤细胞表达CD20和CD10,不同程度地表达CD798、bcl-6、MUM-1等,大于95%的瘤细胞Ki-67阳性;EBV原位杂交显示EBER 1/2阴性;间期FISH有c-myc基因异常.结论 散发性BL属高度侵袭性淋巴瘤,需要与多种其他肿瘤鉴别,明确诊断有助于临床针对性地进行高强度治疗.基于分子水平及蛋白水平多项标志物的检测,可大大减少漏诊和误诊,并为临床的准确诊断和及时治疗提供有力的依据.
目的 探討散髮性Burkitt淋巴瘤(BL)的臨床病理、免疫錶型及分子生物學特徵.方法 對20例散髮性BL病例進行瞭光鏡、免疫組化、EB病毒(EBV)原位雜交及間期熒光原位雜交(FISH)檢測,結閤臨床特徵進行綜閤分析.結果 20例散髮性BL中,男性16例,女性4例;年齡3-14歲,中位年齡9歲.光鏡下部分典型的BL腫瘤細胞瀰漫一緻性增生浸潤,見較明顯的吞噬覈碎片的巨噬細胞形成的"星天現象".部分病例形態學需鑒彆其他腫瘤.免疫組織化學染色顯示,瘤細胞錶達CD20和CD10,不同程度地錶達CD798、bcl-6、MUM-1等,大于95%的瘤細胞Ki-67暘性;EBV原位雜交顯示EBER 1/2陰性;間期FISH有c-myc基因異常.結論 散髮性BL屬高度侵襲性淋巴瘤,需要與多種其他腫瘤鑒彆,明確診斷有助于臨床針對性地進行高彊度治療.基于分子水平及蛋白水平多項標誌物的檢測,可大大減少漏診和誤診,併為臨床的準確診斷和及時治療提供有力的依據.
목적 탐토산발성Burkitt림파류(BL)적림상병리、면역표형급분자생물학특정.방법 대20례산발성BL병례진행료광경、면역조화、EB병독(EBV)원위잡교급간기형광원위잡교(FISH)검측,결합림상특정진행종합분석.결과 20례산발성BL중,남성16례,녀성4례;년령3-14세,중위년령9세.광경하부분전형적BL종류세포미만일치성증생침윤,견교명현적탄서핵쇄편적거서세포형성적"성천현상".부분병례형태학수감별기타종류.면역조직화학염색현시,류세포표체CD20화CD10,불동정도지표체CD798、bcl-6、MUM-1등,대우95%적류세포Ki-67양성;EBV원위잡교현시EBER 1/2음성;간기FISH유c-myc기인이상.결론 산발성BL속고도침습성림파류,수요여다충기타종류감별,명학진단유조우림상침대성지진행고강도치료.기우분자수평급단백수평다항표지물적검측,가대대감소루진화오진,병위림상적준학진단화급시치료제공유력적의거.
Objective To investigate the clinical and pathological features of the sporadic Burkitt's lymphoma(BL),as well as its immunohistochemical and molecular characteristics.Methods 20 cases of sporadic BL were retrospectively studied by analyzing their light microscopy features,immunohistochemical expression,EBV infection detected by in stiu hybridization,chromosomal breakage of c-myc and/or lgH genes by interphase fluorescence in stiu hybridization (FISH),and their clinical manifestation.Results All the 20 cases of sporadic BL occurred in children(3-14 y)including 16 males and 4 females.Microscopically,the medium-sized tumor cells were monomorphic and proliferated in a diffuse pattern showing"starry-sky"with numerous karyorrhectic debris.Mitotic figures were frequently seen.Immunohistochemically,the tumor cells were positive for CD20 and CD10,over 95%positive for Ki-67 and negative for TdT,CD99,MPO. No EBV infection wag found by in situ hybridization in 18 cases.Interphase FISH analysis detected c-myc gene breakage or amplification and/or IgH/c-myc gene breakage in all detected 15 cases.Conclusion Sporadic BL is a high-grade malignant B cell lymphoma.The tumor cell proliferation index is very high.Molecular and immunohistochemical analysis could reduce the incidence of misdiagnosis and thus phys a vital role on its correct diagnosis and appropriate therapy.
