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睾丸原发性淋巴瘤17例临床病理分析

发布时间:2018-11-08 07:13
【摘要】:目的探讨睾丸原发性淋巴瘤(primary testicular lymphoma,PTL)的临床病理学特征。方法回顾性分析17例PTL的临床病理学特征。结果患者年龄37~81岁,中位年龄69岁;以睾丸无痛性肿大为主要临床表现;病变位于左侧6例,右侧10例,双侧1例;肿块最大径2~6 cm。组织学分型:17例PTL中16例(94%)为弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL),1例(6%)为结外NK/T细胞淋巴瘤(鼻型)。免疫表型提示16例DLBCL中14例为非生发中心B细胞样(non-germinal center B-cell-like,non-GCB)型,2例为生发中心B细胞样(germinal center B-cell-like,GCB)型;c-myc与BCL-2或BCL-6抗体共同阳性表达者(c-myc阳性率30%以上且BCL-2阳性率70%以上者)10例。对10例共表达病例行FISH检测,发现仅1例有MYC基因重排,未发现双重打击淋巴瘤(double-hit lymphoma,DHL)。EB病毒原位杂交检测除1例鼻型NK/T细胞淋巴瘤为阳性外均为阴性。Ann Arbor临床分期:Ⅰ+Ⅱ期15例(88%),Ⅲ+Ⅳ期2例(12%)。17例患者均行患侧睾丸根治性切除术,8例DLBCL患者行CHOP或R-CHOP方案化疗。结论 PTL发病率低,主要发生于老年人,最常见的组织学类型为DLBCL,以non-GCB型伴c-myc与BCL-2/BCL-6共表达为主,患者预后差。PTL中很少发现伴随MYC和BCL-2同时基因重排的DHL。PTL术前诊断困难,确诊需依靠病理组织学、免疫表型及分子病理学检查等。
[Abstract]:Objective to investigate the clinicopathological features of primary testicular lymphoma (primary testicular lymphoma,PTL). Methods the clinicopathological features of 17 cases of PTL were retrospectively analyzed. Results the age of the patients was 3781 years with median age of 69 years. The main clinical manifestation was painless testicular enlargement. The lesions were located in 6 cases on the left side, 10 cases on the right side, and 1 case on both sides. The maximum diameter of the mass was 2 ~ 6 cm.. Histological credit type: 16 cases (94%) of PTL were diffuse large B cell lymphoma (diffuse large B cell lymphoma,DLBCL) and 1 case (6%) was extranodular NK/T cell lymphoma (nasal type). The immunophenotype showed that 14 cases of DLBCL were non-germinal center B-cell-like non-GCB type, 2 cases were germinal center B-cell-like (germinal center type. The positive rate of c-myc and BCL-2 or BCL-6 antibody was more than 30% and the positive rate of BCL-2 was more than 70%. FISH detection was performed in 10 coexpression cases. Only 1 case was found to have MYC gene rearrangement, and no double strike lymphoma (double-hit lymphoma,) was found. In situ hybridization of DHL). EB virus was negative for. Ann Arbor clinical staging except for 1 case of nasal NK/T cell lymphoma: 15 cases (88%) were stage 鈪,

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