血管免疫母细胞性淋巴结病及血管免疫母细胞性T细胞淋巴瘤

AngioimmunoblasticlymphadenopathyandangioimmunoblasticT┐cellymphoma

为了深入调查血管免疫母细胞性淋巴结病（ＡＩＬＤ）和血管免疫母细胞性Ｔ细胞淋巴瘤（ＡＩＴＬ）的临床病理、病变性质诸方面，采用了免疫组化和聚合酶链反应（ＰＣＲ）等方法对５例进行了分析。该５例患者均有全身淋巴结肿大（但直径多小于１ｃｍ），肝脾肿大、发热和多项血液指标改变。ＡＩＴＬ时在ＡＩＬＤ病变背景上出现异型的透明Ｔ细胞浸润为诊断和鉴别依据。５例中４例行ＴＣＲ－β重排分析均呈现克隆性改变。并对４例埃泼斯坦－巴尔病毒（ＥＢＶ）感染情况进行分析，其中３例ＥＢＶＤＮＡ阳性。认为ＡＩＬＤ可能是一种与ＥＢＶ感染相关的瘤前病变，发展为淋巴瘤的比例较高。

Toinvestigatetheclinicopathologicalchangesofangioimmunoblasticlym-phadenopathy(AILD)andangioimmunoblasticT-cellymphoma(AITL),5casesofAILDandAITLwereanalyzedbyusingimmunohistochemistryandPolymerasechainreaction(PCR)methods.Theclinicalmanifestationsincludedgenerallymphadenopathy,hepatosplenomegaly,feverandhema-tologicabnormalities.ThediagnosisanddiferntiationofAILDandAITLweredependedonthehistopathologicfeaturesoflymphnodesbiopsy.ThepresenceofclustersofclearcelswithvariableatypiaandpositivityofT-celmarkerwerethemostimportantdiagnosticcriterionforAITL.PCRanalysisofTCR-βrearrangementandEBV-genomewasperformedon4of5cases.AlofthecasesshowedclonalrearrangementofTCR-Band3ofthemwereEBV-DNApositive.TheresultssuggestthatAILDmightbeaprelymphomatouslesion,relatedtoEBVinfectionwithahighincidenceofde-velopingtomalignantlymphoma.