乳腺恶性淋巴瘤3例临床病理分析

Breast malignant lymphoma: a clinicopathologic analysis of 3 cases

目的探讨乳腺恶性淋巴瘤的临床病理特点和鉴别诊断。方法 分析3例乳腺恶性淋巴瘤的临床资料及组织病理学和免疫表型特点,按WHO(2001)淋巴造血组织肿瘤分类进行组织学分型。结果 3例患者平均年龄55岁,临床主要表现为乳腺包块,生长较快,伴有发热、触痛。3例均诊断为弥漫性大B细胞性淋巴瘤,其组织学特点是瘤细胞弥漫性分布,细胞大,核圆形或卵圆形,核膜厚,可见核仁。免疫组化肿瘤细胞CD20、CD79a弥漫阳性,CD45、CK均阴性。结论乳腺恶性淋巴瘤十分少见,确诊依赖组织学和免疫组化检测。该病需要和浸润性小叶癌、小细胞癌、淋巴浆细胞性乳腺炎、乳腺假淋巴瘤等鉴别。

Objective To investigate the clinicopathologic features and differential diagnosis of breast malignant lymphoma.Methods The medical records,histopathologic features and immunophenotype of breast malignant lymphoma were analyzed in three cases.The diagnosis and histological classification were referred to the criteria of the World Health Organization classification for tumours of the hematopoietic and lymphoid tissues(2001).Results The mean age of the 3 patients was 55 years old.The major clinical manifestations were breast mass and rapidly growth,with fever and pain.Three patients were diagnosed as diffuse large B-cell lymphoma.Tumor cells showed a diffuse growth pattern.The large nuclei were round or oval shape with thick nuclear membrane and clear nucleoli.The tumor cells expressed CD20,CD79a,while CD45,CK were negative.Conclusions Breast lymphoma is uncommon.The diagnosis depends on the histologic and immunohistochemical detection and it should be distinguished from invasive lobular carcinoma,small cell carcinoma,plasma cell mastitis、pesudolymphoma of the breast.