原发性肾上腺非霍奇金淋巴瘤3例并文献复习

Primary adrenal lymphoma:three cases report and review of the literature

目的探讨原发性肾上腺恶性淋巴瘤的临床病理特征。方法对3例原发性肾上腺恶性淋巴瘤进行临床、病理组织学和免疫组织化学观察,并结合文献探讨其临床表现、病理形态及鉴别诊断。结果本病临床上无特异性,组织学上瘤细胞呈弥漫片状分布,细胞体积较大,多呈圆形或卵圆形,核仁明显,核深染,异型性明显,核分裂象易见。免疫表型:瘤细胞CD45、CD20、CD79α阳性,CD3、CK、S100蛋白、CEA、Syn及CgA阴性。结论原发性肾上腺恶性淋巴瘤是一种罕见的恶性度较高的肿瘤,预后差。病理诊断上应与继发性肾上腺恶性淋巴瘤鉴别。

Purpose To describe the clinicopathological features of primary adrenal lymphoma(PAL). Methods Clinical data,pathologic changes and immunohistochemical findings were observed,and differential diagnosis was discussed in three cases of PAL by review of the literature. Results The presenting symptoms were nonspecific.Histologically,the tumor cells showed a round or oval shape with prominent nucleoli,forming the structures of sold pattern or diffuse sheet.The neoplastic cells showed frequent mitosis.Immunohistochemically,the tumor cells were positive for CD45,CD20 and CD79α,but negative for CD3,CK,CEA,CgA,Syn and S-100 protein. Conclusions PAL is extremely rare tumor with a high grade of malignancy and poor prognosis. It should be differentiated from the secondary adrenal lymphoma.