甲状腺恶性淋巴瘤与淋巴细胞性甲状腺炎的临床病理与免疫表型分析

Clinicopathologic aud immunopheuotypic studies for thyroid non-Hodgkin's lymphoma and Hashimoto's thyroiditis

本文分析了１０例原发性甲状腺恶性淋巴瘤（ＴＬ）及８６例淋巴细胞性甲状腺炎（ＬＴ）的临床病理特征。对其中１１例重度ＬＴ及ＴＬ作了免疫标记。ＴＬ中８例为Ｂ细胞性，２例为Ｔ细胞性；７例见淋巴上皮病损，３例见明显甲状腺外浸润，５例ＴＬ残留组织中见ＬＴ背景，２例符合结外边缘带Ｂ细胞淋巴瘤。１１例重度ＬＴ中见淋巴细胞内陷于滤泡上皮间，免疫标记示免疫球蛋白轻链多克隆性。本文讨论了甲状腺粘膜相关组织淋巴瘤的病理特征及ＴＬ的诊断标准问题，提出ＴＬ与ＬＴ有密切关系，ＴＬ可能来自原发存在的ＬＴ。

cases of primary thyroid malignant lymphoma and 11 severe cases with thyroiditis selected from 96 specimens of throidectomies were studied. Histologically,there were lymphoepithelial lesions, heterogeneous lymphocyte infiltration, destruction of thyroid structure and focal necrosis in thyroid lymphoma.Immune labelling showed monoclonal light chain in nature. There were 2 cases with extranodal marginal zone B-cell lymphoma constituted chiefly by centrocyte-like cells growing around the follicle with significant lymphoepithelial lesions, their prognoses being relatively good. The analysis reveals that the occurrence of thyroid lymphoma is closely related to lymphocytic thyroiditis. Most thyroid lymphoma and mucosa-associated lymphoid tissue-malignant lymphoma (MALT-ML) in other parts of the body have common immune labelling characteristics. The cells in thyroid lymphoma probably are derived from the parafollicular B-cells,and the low grade malignancy possibly can transform into high malignancy. The prognosis not only depends on the pathological gradation, but also on the clinical stage of the disease.