中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2010年
4期
230-234
,共5页
孔蕴毅%戴波%孔今城%陆洪芬%施达仁
孔蘊毅%戴波%孔今城%陸洪芬%施達仁
공온의%대파%공금성%륙홍분%시체인
淋巴瘤,T细胞%皮肤%免疫表型分型%诊断,鉴别
淋巴瘤,T細胞%皮膚%免疫錶型分型%診斷,鑒彆
림파류,T세포%피부%면역표형분형%진단,감별
Lymphoma,T-cell,cutaneous%Immunophenotyping%Diagnosis,differential
目的 探讨原发皮肤间变性大细胞淋巴瘤(CALCL)多样的临床病理特征、免疫表型,并行预后相关性分析.方法 收集CALCL 44例,总结临床病理资料、治疗情况和随访资料.常规HE染色和免疫组织化学EnVision染色行组织病理形态学观察.结果 44例CALCL患者临床皮损以结节、肿块和(或)斑块为主,可伴溃疡形成.四肢最常受累.39例获得随访,生存率为87.2%(34/39).46.2%(18/39)患者有疾病复发,统计学分析显示年龄＞50岁与累犯≥2个解剖部位的病例组复发率显著升高(P＜0.05).44例CALCL中,31例为经典型,6例为小细胞变型,另有7例为富于中性粒细胞/嗜酸性粒细胞变型.CD30、CD45、CD45RO、CD43、CD3、细胞毒性蛋白和上皮细胞膜抗原的阳性率分别为100%(44/44)、91.2%(31/34)、82.6%(19/23)、94.7%(18/19)、70.0%(28/40)、73.3%(22/30)和31.8%(7/22).CD4~+/CD8~+、CD4~-/CD8~+和CD4~-/CD8~-免疫表型的比例分别为58.3%(21/36)、22.2%(8/36)和19.4%(7/36).仅1例(3.7%)同时表达CD56.结论 CALCL是一类低度恶性皮肤T细胞淋巴瘤,组织学形态多变,认识CALCL特殊类型有助于避免与其他类型淋巴瘤和炎症性病变相混淆.年龄＞50岁和累犯≥2个解剖部位CALCL患者与高复发率相关.
目的 探討原髮皮膚間變性大細胞淋巴瘤(CALCL)多樣的臨床病理特徵、免疫錶型,併行預後相關性分析.方法 收集CALCL 44例,總結臨床病理資料、治療情況和隨訪資料.常規HE染色和免疫組織化學EnVision染色行組織病理形態學觀察.結果 44例CALCL患者臨床皮損以結節、腫塊和(或)斑塊為主,可伴潰瘍形成.四肢最常受纍.39例穫得隨訪,生存率為87.2%(34/39).46.2%(18/39)患者有疾病複髮,統計學分析顯示年齡＞50歲與纍犯≥2箇解剖部位的病例組複髮率顯著升高(P＜0.05).44例CALCL中,31例為經典型,6例為小細胞變型,另有7例為富于中性粒細胞/嗜痠性粒細胞變型.CD30、CD45、CD45RO、CD43、CD3、細胞毒性蛋白和上皮細胞膜抗原的暘性率分彆為100%(44/44)、91.2%(31/34)、82.6%(19/23)、94.7%(18/19)、70.0%(28/40)、73.3%(22/30)和31.8%(7/22).CD4~+/CD8~+、CD4~-/CD8~+和CD4~-/CD8~-免疫錶型的比例分彆為58.3%(21/36)、22.2%(8/36)和19.4%(7/36).僅1例(3.7%)同時錶達CD56.結論 CALCL是一類低度噁性皮膚T細胞淋巴瘤,組織學形態多變,認識CALCL特殊類型有助于避免與其他類型淋巴瘤和炎癥性病變相混淆.年齡＞50歲和纍犯≥2箇解剖部位CALCL患者與高複髮率相關.
목적 탐토원발피부간변성대세포림파류(CALCL)다양적림상병리특정、면역표형,병행예후상관성분석.방법 수집CALCL 44례,총결림상병리자료、치료정황화수방자료.상규HE염색화면역조직화학EnVision염색행조직병리형태학관찰.결과 44례CALCL환자림상피손이결절、종괴화(혹)반괴위주,가반궤양형성.사지최상수루.39례획득수방,생존솔위87.2%(34/39).46.2%(18/39)환자유질병복발,통계학분석현시년령＞50세여루범≥2개해부부위적병례조복발솔현저승고(P＜0.05).44례CALCL중,31례위경전형,6례위소세포변형,령유7례위부우중성립세포/기산성립세포변형.CD30、CD45、CD45RO、CD43、CD3、세포독성단백화상피세포막항원적양성솔분별위100%(44/44)、91.2%(31/34)、82.6%(19/23)、94.7%(18/19)、70.0%(28/40)、73.3%(22/30)화31.8%(7/22).CD4~+/CD8~+、CD4~-/CD8~+화CD4~-/CD8~-면역표형적비례분별위58.3%(21/36)、22.2%(8/36)화19.4%(7/36).부1례(3.7%)동시표체CD56.결론 CALCL시일류저도악성피부T세포림파류,조직학형태다변,인식CALCL특수류형유조우피면여기타류형림파류화염증성병변상혼효.년령＞50세화루범≥2개해부부위CALCL환자여고복발솔상관.
Objective To study the cilnicopathologic features,immunophenotype and prognosis of primary cutaneous anaplaatic large cell lymphoma(CALCL).Methods Histopathologic evaluation and immunohistochemical study by Envision method were carried out in 44 archival cages of CALCL The clinical information and foilow-up data were analyzed.Results The patients presented with skin nodules,masses or plaques,sometimes associated with ulceration.The commonest sites of involvement were the extremities.Follow-up data were available in 39 patients.The overall snrvival rate was 87.2%(34/39).Disease relapses were detected in 46.2%(18/39)of the patients.Statistical analysis indicated that patients older than 50 years of age or with no less than two involved anatomic sites were more likely to have disease relapses (P＜0.05).Histologically,31 cases were classified as common variant,6 cases as small cell variant and 7 cases as neutrophil/eosinophil-rich variant.Immunohistochemical study showed that the rates of expression of CD30,CD45,CD45RO,CD43,CD3,cytotoxic protein and epithelial membrane antigen were 100%(44/44),91.2%(31/34),82.6%(19/23),94.7%(18/19),70.0%(28/40),73.3%(22/30)and 31.8%(7/22),respectively.The CD4~+/CD8~-,CD4~-/CD8~+ and CD4~-/CD8~- immunophenotypes were found in 58.3%(21/36),22.2%(8/36)and 19.4%(7/36)of the CALCL cases,respectively.Only one case(3.7%)expressed CD56.Conclusions CALCL is a form of low-grade primary cutsneous T-cell lymphoma with a wide spectrum of clinicopathologic pattern.Special variants of CALCL should not be confused with other types of cutaneous lymphomas and inflammatory lesions.CALCL patients older than 50 years of age or with no less than two involved anatomic sites are more likely to have disease relapses.
