母细胞型套细胞淋巴瘤的临床病理观察

Blastic variant of mantle cell lymphoma: a clinicopathological study

目的探讨母细胞型套细胞淋巴瘤(BV_MCL)的病理特征、免疫表型、诊断和鉴别诊断。方法对2例BV-MCL行HE和免疫组化染色观察。结果1例为经典型母细胞型,肿瘤细胞弥漫、中等偏大、染色质细,核分裂87个/10 HPF;另1例为多形型母细胞型,肿瘤细胞弥漫、多形,中等大的细胞与大细胞混杂,核染色质粗,可见明显的核仁,核分裂36个/10 HPF。2例均cyclinD1(+)。结论BV-MCL少见,是MCL的一种变型,其病理形态和免疫表型特殊,需要与弥漫性大B细胞淋巴瘤、前驱B淋巴母细胞白血病/淋巴瘤等鉴别。

Objective To observe the morpholngic and ifeatures of blastic variant of mantle cell lymphoma （BV-MCL）, and to investigate it diagnosis and differential diagnosis. Methods 2 cases of BV-MCL were observed with H-E staining and immunohistochemical techniques. Results One case was classic blastoid variant,in which the neoplastic cells were medium to large in size with dispersed chromatin, high mitotic rate （87/10 HPF） and a diffuse growth pattern; another case was pleomorphic blastoid variant, in which the neoplastic cells were composed of plemorphic medium and large cells with clumped chromatin, obvious nucleoli and a high mitotic rate （36/10 HPF）. Both were cyclinD1 positive. Conclusion BV-MCL is a rare MCL variant characterized by unique morphology and immunohistochemistry. It is important to differentiate it from diffuse large B cell lymphoma and precursor B-lymphoblastic leukaemia/lymphoma in the diagnosis.