摘要
目的：结合文献讨论脾脏边缘带淋巴瘤的诊断标准。方法：回顾性分析一例脾脏边缘带淋巴瘤。结果;此例临床症状为牌中度肿大、贫血、体重减轻、发热等，伴有牌外转移（外周血及骨髓内见幼稚淋巴细胞）;组织学主要侵犯白髓的外套层和（或）边线带，红脸亦受累，病变区可见与正常边缘带细胞相似的肿瘤细胞;免疫学I，CA、L26、bcl-2、k、IgA阳性;MAC387、lysozyme散在阳性出UCHL-1、BerH2、EMA阴性。结论：该病是一种独特的外周B细胞淋巴瘤，应与毛细胞性白血病、牌外套层细胞淋巴瘤、脾脏绒毛状淋巴瘤和B粘膜相关淋巴瘤鉴别。
Purpose: To investigate the diagnostic standard of splenic marginal zone lymphoma through reviewing literatures.Method: A case of splenic marginal zone lymphoma was analysed retrospectvely. Results: The clinical characters was the median splenomegaly, anemia, weight loss and fever, with extrasplenic involvement (germinal lymphocytes can be seen in the peripheral blood and the bone marrow). Histologically, it involves mainly in the mantle zone of the white pulp and/or the marginal zone, somtimes the involvement of the red pulp can be seen too. Neoplastic cells similar to the normal marginal zone cells can be seen in the lesions. Immunologically, LCA、 L26、 bcL-2、 K、IgA were positive, MAC387 and lysozyme was diffusely positive, while UCHL1、 BerH2、 EMA were negative. Camclusions: It is considered as a distinctive peripheral B-cell lymphoma, and should distinguish with hairy cell leukemia,splenic mantle cell lymphoma, splenic lymphoma with villous lymphoma and B mucosa-associated lymphoma.
