CAJ | 학술논문

目的探讨原发乳腺淋巴瘤(PBL)的病理诊断和预后.方法复习21例PBL的临床资料并进行随访.病理诊断依据WHO关于淋巴造血组织肿瘤的分类(2008版)进行.采用免疫组织化学SP法行免疫表型检测,选用的抗体有CD20、CD3ε、CD10、bcl-6、MUM-1、CD5、bcl-2、CD23、CD10、细胞周期蛋白D1、CD43和Ki-67等.结果 (1)21例均为女性,中位年龄48岁,右乳11例(52.4%),左乳10例(47.6%).最常见的临床表现是受累乳腺单发、无痛性肿块.Ann Arbor分期:20例为Ⅰ～Ⅱ期(95.2%),1例为Ⅳ期(4.8%).国际预后指数:19例为0～1分,2例为2～3分.东方肿瘤协作组织(ECOG)体力状态评分:19例为0分,2例为1分.(2)21例(100%)均为弥漫性大B细胞淋巴瘤.免疫表型检测:21例均表达CD20抗原,14例(66.7%)表达MUM-1,5例(23.8%)表达bol-6,CD10均为阴性表达,1例(4.8%)表达CD5,13例(61.9%)表达bcl-2.Ki-67阳性指数:10例(47.6%)≤59%,7例(33.3%)为60%～89%,4例(19.1%)≥90%,其中位数为60%.21例均符合非生发中心B细胞样型肿瘤.(3)13例(64%)获得随访资料,其1年、3年和5年生存情况分别为11例、7例和3例.结论该组21例PBL均为DLBCL,且均符合非生发中心B细胞来源的肿瘤.其诊断应充分排除系统性淋巴瘤累及乳腺.
목적 탐토원발유선림파류(PBL)적병리진단화예후.방법 복습21례PBL적림상자료병진행수방.병리진단의거WHO관우림파조혈조직종류적분류(2008판)진행.채용면역조직화학SP법행면역표형검측,선용적항체유CD20、CD3ε、CD10、bcl-6、MUM-1、CD5、bcl-2、CD23、CD10、세포주기단백D1、CD43화Ki-67등.결과 (1)21례균위녀성,중위년령48세,우유11례(52.4%),좌유10례(47.6%).최상견적림상표현시수루유선단발、무통성종괴.Ann Arbor분기:20례위Ⅰ～Ⅱ기(95.2%),1례위Ⅳ기(4.8%).국제예후지수:19례위0～1분,2례위2～3분.동방종류협작조직(ECOG)체력상태평분:19례위0분,2례위1분.(2)21례(100%)균위미만성대B세포림파류.면역표형검측:21례균표체CD20항원,14례(66.7%)표체MUM-1,5례(23.8%)표체bol-6,CD10균위음성표체,1례(4.8%)표체CD5,13례(61.9%)표체bcl-2.Ki-67양성지수:10례(47.6%)≤59%,7례(33.3%)위60%～89%,4례(19.1%)≥90%,기중위수위60%.21례균부합비생발중심B세포양형종류.(3)13례(64%)획득수방자료,기1년、3년화5년생존정황분별위11례、7례화3례.결론 해조21례PBL균위DLBCL,차균부합비생발중심B세포래원적종류.기진단응충분배제계통성림파류루급유선.
Objective To investigate the clinicopathologic and immunophenotypic features of primary breast lymphoma (PBL) and to discuss the diagnosis pof the tumor. Methods Twenty-one cases of PBL with follow up data were clinically reviewed. The histologic diagnosis of the tumor was based on the Pupdated WHO Classification of tumors of hematopoietic and lymphoid tissues (2008 ). Immunohistochemistry was performed by SP method and antibodies uselected were as follows; CD20, CD3ε, CD10, Bcl-6, MUM-1, CD5, Bcl-2, CD23, CD10, cyclin Dl, CD43 and Ki67. Results (1) All 21 patients were female wand the median age of patients was 48 years. The right and the left breasts were involved in 11 (52.4% ) and 10 patients (47. 6% ), respectively. According to Ann Carbor staging system, 20 cases were stage Ⅰ -Ⅱ (95. 2% ) , and the remaining case was stage Ⅳ (4. 8% ). For the international prognostic index (IPI) , 19 cases mwere score 0- 1, and 2 cases were score 2-3. For ECOG score, 19 cases were 0, and the remaining 2 cases were 1. (2) Histologically, all 21 cases (100%) were pDLBCL Immunohistochemically, the frequency of antigen expression was as follows: CD20 (100% ) , MUM-1 (14/21,66. 7% ), bcl-6 (5/21, 23.8%), CD10 (0), (bcl-2 (13/21,61.9%), CD5 (1/21,4.8%); Ki-67 index; 10 cases (47.6%) were less than 59% , with the expression of seven cases (33. 3% ) being 60% - 89% , and cmore than 90% in the remaining four cases (19. 1% ). The median Ki-67 index was 60%. All the cases were considered non germinal center B-cell-like type of 2DLBCL. (3) Follow-up data was available in 64% of the cases.f2 One, two and five-year survival rates were 11 cases, 7 cases and 3 cases, respectively. Conclusion All the cases of PBL in the current study were DLBCL, non germinal center B-cell-like type, and a diagnosis of PBL can only be established after excluding breast involvement in systemic lymphoma.