原发性软组织内非霍奇金淋巴瘤2例并文献复习

Primary Non-Hodgkin's Lymphoma of Soft Tissues: A Report of 2 Cases and Review of the Literature

目的探讨原发性软组织内非霍奇金淋巴瘤的临床病理学特征。方法对2例原发性软组织内非霍奇金淋巴瘤进行临床、病理组织学和免疫组织化学观察,并结合文献探讨其临床表现、病理形态及鉴别诊断。结果本病临床上无特异性,2例患者平均年龄57岁。证实均为弥漫性非霍奇金淋巴瘤,1例为B细胞性,1例为T细胞性。组织学上见肿瘤细胞弥漫分布,细胞呈圆形或卵圆形,核仁明显,核分裂像易见。免疫表型LCA、CD43、CD3、CD20、CD79α阳性;Vimentin、Actin、Myoglobin、Myosin、EMA、CK、CgA、Syn、NSE、Melon A和S-100 2例瘤细胞均不表达。结论原发性软组织淋巴结外恶性淋巴瘤比较少见,中老年患者出现软组织内弥漫性肿块,应考虑到原发性恶性淋巴瘤的可能性。本病的明确诊断依赖病理学,而免疫组化染色在鉴别诊断中发挥重要作用。

Objective To describe the clinic pathological behavior of primary non-Hodgkin＇ s lymphoma of soft tissues and to analyze the immunophenotypes and morphological features. Methods Clinical data, pathologic changes and immunohistochemical findings were observed, and differential diagnosis was discussed in the 2 cases of primary lymphoma of soft tissues by review of the literature. Results The presenting symptoms were nonspecific. The average age of the patients was 57 years old. All the cases were diffuse non-Hodgkin＇ s lymphoma, the lymphoma cells in 1 case were derived from B-lymphocyteand in 1 case from T-lymphocyte. Histologically, the tumor cells showed a round or oval shapes with prominent nucleoli, forming the structures of diffuse sheet. The neoplastic cells showed frequent mitosis. By immunohistochemistry, the tumor cells were positive for LCA, CD43, CD3, CD20 and CD79ct, but negative for Vimentin, Aciin, Myoglobin, Myosin, EMA, CK, CgA, Syn, NSE,Melon A and S-100. Conclusions The primary lymphoma of soft tissues is rare, when a diffuse mass of soft tissues occurs in a middle or old age of man or woman, we should consider the possibility of primary lymphoma. The definite diagnosis of the disease depends on pathological examination, immunohistochemistry plays an important role in the differential diagnosis of other small round cell soft tumors.