肺淋巴瘤样肉芽肿5例临床病理分析

发布时间：2018-01-05 06:15

本文关键词：肺淋巴瘤样肉芽肿5例临床病理分析　出处：《临床与实验病理学杂志》2016年08期 　论文类型：期刊论文

【摘要】：目的探讨肺淋巴瘤样肉芽肿(pulmonary lymphomatiod granulomatosis,PLG)临床病理学特征。方法回顾性分析5例PLG的临床资料、组织学形态、免疫表型及分子生物学特点,并复习相关文献。结果 5例患者均为男性,年龄7~74岁,平均36.6岁;其中2例有发热病史;镜下均见中至大量异型淋巴样细胞弥漫浸润,其中3例可见大片凝固性坏死及显著的血管壁异型淋巴样细胞浸润伴纤维素样坏死;免疫表型:异型淋巴样细胞CD20、PAX-5、LMP1均阳性,EBER原位杂交检测显示数量不等的阳性,背景小淋巴细胞CD2、CD3、CD5阳性。依据反应性淋巴细胞背景中EB病毒阳性B细胞的比例,诊断PLG 3级2例,PLG 2级2例,PLG1~2级1例;术后随访时间6~16个月,平均9个月,均无复发和转移。结论 PLG是一种EB病毒相关的B细胞淋巴组织增殖性疾病,成年人居多,症状多样,肺部呈多发或单发病灶。诊断主要依靠病变中大量炎性细胞伴多少不等的中等大至大的异型B淋巴细胞且EB病毒阳性,以及嗜血管现象和灶片状坏死。同时应注意排除肺部炎性疾病和霍奇金淋巴瘤。
[Abstract]:Objective to investigate pulmonary lymphomatiod granulomatosis of pulmonary lymphoma granuloma. Methods the clinical data, histological morphology, immunophenotypic and molecular biological characteristics of 5 cases of PLG were analyzed retrospectively. The average age was 36.6 years. Two of them had a history of fever. Under the microscope, a large number of atypical lymphoid cells were infiltrated, 3 of which showed large coagulative necrosis and significant infiltration of vascular wall abnormal lymphoid cells with cellulose like necrosis. Immunophenotypes: CD20, PAX-5 and LMP1 were all positive. EBER in situ hybridization showed that the number of CD2 + CD2 + CD3 was different, and CD2 + CD3 was detected by EBER in situ hybridization. According to the proportion of EB virus positive B cells in reactive lymphocyte background, 2 cases of PLG grade 3 and 2 cases of PLG grade 2 were diagnosed as grade 2 of PLG and 1 case of grade 2 of PLG. The follow-up time was 6 ~ 16 months (mean 9 months), and no recurrence or metastasis was found. Conclusion PLG is a proliferative disease of B cell lymphoid tissue associated with Epstein-Barr virus (EBV). The diagnosis mainly depends on the large number of inflammatory cells in the lesion accompanied by varying amounts of medium to large abnormal B lymphocytes and EBV positive. Haemophilus and focal necrosis. At the same time should be careful to exclude pulmonary inflammatory diseases and Hodgkin's lymphoma.
【作者单位】：湖北省宜昌市中心人民医院病理科;北京友谊医院病理科;
【分类号】：R563
【正文快照】： 淋巴瘤样肉芽肿(lymphomatiod granulomatosis,LYG)是一种结外血管中心性和血管破坏性淋巴组织增殖性病变,其由EB病毒感染的不典型的多形性B细胞浸润和大量混合性反应性T细胞组成,缺乏真正的肉芽肿特点,可进展为EB病毒阳性的弥漫大B细胞淋巴瘤[1]。临床罕见,其常发生于成人,但

【相似文献】