弥漫性大B细胞淋巴瘤变型的病理及免疫表型分析

Analysis of Histopathologic Features and Immunophenotype in Morphologic Variants of Diffuse Large B-cell Lymphoma

目的:探究弥漫性大B细胞淋巴瘤(DLBCL)变型的组织学特点及免疫表型。方法:收集108例DLBCL,总结其临床资料和组织病理学特点,进行组织微阵列免疫组化检测CD10、bcl-6的表达。结果:中心母细胞型(CB)为89.8%,免疫母细胞型(IB)2.8%,间变性大B细胞型(ALCL)1.9%,富于T细胞的B细胞型(TCRBCL)1.9%,其它变型3.7%;23.1%见较多背景反应细胞,41.7%伴有纤维化基质,21.3%有浆细胞分化,14.8%血管丰富、含有成片印戒样细胞,8.3%见坏死,3.7%见嗜酸细胞、硬化带。CB中44.2%CD10、48.1%bcl-6阳性,2例ALCL均阳性,而3例IB均阴性。结论:各变型有B细胞淋巴瘤共有的病理组织学特点,又有其各自的病理特征;CD10/bCL-6表达在识别变型中有重要意义。

Objective： To study histopathologic features and immunophenotype of morphologic variants of DLBCL. Methods： A total of 108 cases with DLBCL were studied and immunohistochemical staining was carried out for CD10/bcl-6 in DLBCL tissue microarry. Results： Morphologic variants of the 108 cases were shown as follows： 89.9% centroblastic, 2.8% immunoblastic, 1.9% anaplastic large B-cell type, 1.9% T cell rich B cell type and 3.7% others. The cases with DLBCL indicated the rich reactive cell in 23.1%, fibrillary matrix in 41.7%, plasmacytic differentiation in 21.3%, rich blood ves- sel in 14.8%, signet ring cells in 14.8%, necrosis in 8.3%, eosinophils in 3.7% and bands of sclerosis in 3.7%. Fibrillary matrix and rich reactive cell were frequently seen in any of variants. CD10 and bcl- 6 was positive in 44.2%, 48.1% of CB and in 2/2 cases with ALCL, respectively, but negative in 3/3 IB. Conclusions： DLBCL variants have similar and special histopsthology features of B cell lymphoma. CD10/BCL-6 expression pattern may be helpful in identifying main variants of DLBCL.