诊断病理学杂志
診斷病理學雜誌
진단병이학잡지
CHINESE JOURNAL OF DIAGNOSTIC PATHOLOGY
2009年
6期
425-428
,共4页
淋巴组织增生%鼻咽部%诊断%鉴别诊断
淋巴組織增生%鼻嚥部%診斷%鑒彆診斷
림파조직증생%비인부%진단%감별진단
Lymphoproliferation%Nasopharynx%Diagnosis%Differentiatl diagnosis
目的 总结鼻咽部良性淋巴组织增生(NBLA)的临床病理特点、诊断及鉴别诊断要点,提高对NBLA的认识和病理诊断水平.方法 观察209例NBLA的临床及组织病理学,用免疫组化EnVision法检测60例病变组织中浸润的淋巴细胞、雌激素(ER)和孕激素(PR)的表达情况,用原位杂交方法对16例病变组织进行了EBER原位检测.结果 镜下可将NBLA分为滤泡型(188/209)及弥漫型(21/209);黏膜固有层浅层可见浆细胞灶状或带状浸润占56%(117/209),淋巴上皮样病变占99%(207/209),血管壁浸润占34.9%(73/209).免疫组化:滤泡型CD79a和CD20阳性细胞集中于套区及生发中心,CD10阳性细胞位于生发中心,bcl-2阳性细胞主要位于套区,CD3、CD45RO阳性细胞主要分布于弥散淋巴组织.弥漫型CD79a和CD20阳性细胞与CD3和CD45RO阳性细胞混杂分布,bcl-2阳性细胞弥漫分布,CD10(-).淋巴上皮样病变内浸润的淋巴细胞主要是CD20和CD79a(+),浸润血管壁的淋巴细胞以CD3和CD45RO(+)为主.17例(17/60)个别细胞ER弱(+),PR均(-).16例EBER均(-).结论 NBLA镜下可分为滤泡型和弥漫型,弥漫型应注意与多种B细胞淋巴瘤鉴别,其发病与病变部位的ER、PR及EB病毒感染无关.
目的 總結鼻嚥部良性淋巴組織增生(NBLA)的臨床病理特點、診斷及鑒彆診斷要點,提高對NBLA的認識和病理診斷水平.方法 觀察209例NBLA的臨床及組織病理學,用免疫組化EnVision法檢測60例病變組織中浸潤的淋巴細胞、雌激素(ER)和孕激素(PR)的錶達情況,用原位雜交方法對16例病變組織進行瞭EBER原位檢測.結果 鏡下可將NBLA分為濾泡型(188/209)及瀰漫型(21/209);黏膜固有層淺層可見漿細胞竈狀或帶狀浸潤佔56%(117/209),淋巴上皮樣病變佔99%(207/209),血管壁浸潤佔34.9%(73/209).免疫組化:濾泡型CD79a和CD20暘性細胞集中于套區及生髮中心,CD10暘性細胞位于生髮中心,bcl-2暘性細胞主要位于套區,CD3、CD45RO暘性細胞主要分佈于瀰散淋巴組織.瀰漫型CD79a和CD20暘性細胞與CD3和CD45RO暘性細胞混雜分佈,bcl-2暘性細胞瀰漫分佈,CD10(-).淋巴上皮樣病變內浸潤的淋巴細胞主要是CD20和CD79a(+),浸潤血管壁的淋巴細胞以CD3和CD45RO(+)為主.17例(17/60)箇彆細胞ER弱(+),PR均(-).16例EBER均(-).結論 NBLA鏡下可分為濾泡型和瀰漫型,瀰漫型應註意與多種B細胞淋巴瘤鑒彆,其髮病與病變部位的ER、PR及EB病毒感染無關.
목적 총결비인부량성림파조직증생(NBLA)적림상병리특점、진단급감별진단요점,제고대NBLA적인식화병리진단수평.방법 관찰209례NBLA적림상급조직병이학,용면역조화EnVision법검측60례병변조직중침윤적림파세포、자격소(ER)화잉격소(PR)적표체정황,용원위잡교방법대16례병변조직진행료EBER원위검측.결과 경하가장NBLA분위려포형(188/209)급미만형(21/209);점막고유층천층가견장세포조상혹대상침윤점56%(117/209),림파상피양병변점99%(207/209),혈관벽침윤점34.9%(73/209).면역조화:려포형CD79a화CD20양성세포집중우투구급생발중심,CD10양성세포위우생발중심,bcl-2양성세포주요위우투구,CD3、CD45RO양성세포주요분포우미산림파조직.미만형CD79a화CD20양성세포여CD3화CD45RO양성세포혼잡분포,bcl-2양성세포미만분포,CD10(-).림파상피양병변내침윤적림파세포주요시CD20화CD79a(+),침윤혈관벽적림파세포이CD3화CD45RO(+)위주.17례(17/60)개별세포ER약(+),PR균(-).16례EBER균(-).결론 NBLA경하가분위려포형화미만형,미만형응주의여다충B세포림파류감별,기발병여병변부위적ER、PR급EB병독감염무관.
Objective To summarize the clinicopathologic features and differential diagnosis of nasopharyneal benign lymphadenosis (NBLA), and to improve its diagnostic level. Methods 209 cases of NBLA were analyzed with their clinical findings and histopathology. EnVision immunohistochemical staining was performed in 60 cases to detect lymphocytic markers, ER and PR, and in situ hybridization of EBER used in 16 cases. Results The two histological types of NBLA were distinguished: follicle type (188/209)and diffuse type (21/209). Plasma cells were found focal or sheet-like infiltration at superficial proper layer in 117 cases. 207 cases had lymphoepithelia-like lesion and 73 cases had vessel wall infiltration phenomenon. Immunohistochemically, follicle type showed mantle zone and germinal center were mainly positive for CD79a and CD20. The follicle centre cells expressed CD10. bcl-2 was mainly expressed in mantle zone. Diffuse lymphoid tissue was mainly positive for CD3 and CD45RO. Diffuse type showed the cells expressed CD79a, CD20, CD3 and CD45RO. CD10 was negative and bcl-2 was diffusely positive. Lymphocytes among the lymphoepithelial-like lesion was mainly B-cell and the infiltrating vessel wall was mainly T-cell. Individual cells had weak immunoreactivity to ER and all cases were negative for PR. The tests for EBER were negative. Conclusion NBLA has follicle type and diffuse type, and diffuse type should be distinguished from B cell lymphoma. Accurate diagnosis of NBLA requires correlation of medical record, histological features and immunostaining results. Its pathogenesis is not correlated with ER, PR and EB virus infection.
