Burkitt淋巴瘤11例临床病理分析

Burkitt’s lymphoma:a clinicopathological study of 11 cases

目的探讨Burkitt淋巴瘤（BL）的临床病理特征、诊断和鉴别诊断。方法收集11例BL和10例弥漫大B细胞淋巴瘤（DLBCL）,采用免疫组化EnVision二步法检测肿瘤细胞免疫表型,标记抗体为CD20、PAX-5、CD3、CD7、CD10、bcl-2、bcl-6、MUM-1、Ki-67;采用EBER原位杂交方法检测肿瘤细胞的EBV感染情况。结果根据细胞形态BL分为3种类型：经典型8例,浆样分化型1例,非典型性BL/BL样型2例。BL和DLBCL的所有病例CD20和PAX-5（＋）。BL中bcl-2和MUM-1的表达率明显低于DLBCL（P〈0.01）,而同时表达CD10（＋）/bcl-2（-）/bcl-6（＋）和Ki-67≥95%的病例明显多于DLBCL（P〈0.01）。结论BL是一种高度恶性的B细胞淋巴瘤,免疫组化在BL的诊断及鉴别诊断中有重要作用。BL的倍增时间短,宜采取短疗程、高强度化疗方案。

Objective To observe the chnicopathological features, diagnosis and differential diagnosis of Burkitt＇s lymphoma （BL）. Methods 11 cases of BL and 10cases of diffuse large B cell lymphoma （DLBCL） were collected and immunohistochemical stains conducted for CD20, PAX-5, CD3, CD7, CD10, bcl-2, bcl-6, MUM-1 and ki-67. The expression of EBER was detected by in situ hybridization. Results According to the histological changes, BL could be divided into 3 subtypes： typical BL （8 cases）, plasmacytoid BL （1 case）, and atypical/Burkitt-like BL （2 cases）. All cases of BL and DLBCL were CD20 ＋ and PAX-5 ＋ . There were significant differences in the expression of bcl-1, MUM-1, and ki-67 （ ≥95% ） between BL and DLBCL （ P 〈 0.01 ）. The typical immunophenotype of CD10 ＋/bcl-2-/bcl-6 ＋ was present in 11 of 11 BLs, compared with 1 of 10 DLBCLs （ P 〈 0.01 ）. Conclusion BL is an aggressive B cell malignant lymphoma. Using a panel of antibodies is helpful in the differential diagnosis of BL. BL has sharply incressed proliferating index, and should be treated by high intensive, and short-term chemotherapy.