胃肠道B淋巴细胞淋巴瘤的病理诊断

Pathologic Diagnosis of Primary B cell Lymphoma of Gastrointestinal Tract

总结近２年１０例胃肠道Ｂ淋巴细胞淋巴瘤的病理特征，结果如下：大体检查肿块与胃癌无特别差异，镜下特征为肿瘤细胞呈现多样性。部分病例主要成份为中心细胞样细胞（ＣＣＬ）或主要成分为小淋巴细胞及裂－无裂细胞；部分病例有滤泡结构及淋巴上皮病变，而另一些病例则未见此种病变。有些病例与胃癌组织学图像难以鉴别。免疫组化结果：１０例肿瘤ＣＤ２０（＋），瘤细胞膜内侧胞浆显示棕黄色颗粒，证实为Ｂ淋巴细胞来源肿瘤。ＣＤ４５ＲＯ、ＣＫ均阴性。认为，性别、年龄及临床表现不具备诊断胃肠道Ｂ淋巴细胞淋巴瘤特异性价值，常规病理组织学检查有一定的诊断意义。

Following pathologic features were concluded from ten cases of primary B cell lymphoma of gastrointestinal tract found in our department in latest two years: There is no special difference between the primary B cell lymphoma of gastrointestinal tract and gastric carcinoma by gloss appearences. Under microscope the sarcoma cells have multiple appearance. In some cases, the main component is centrocyte like cells or small lymphocite and cleaved noncleaved cells. In some cases, there are follicular structures and lymphoepithetial lesion. But in some other cases, no such pathological changes were found. Some cases can not be distinguished from gastronic carcinoma on histologic features. Ten cases of lymphoma of gastrointestinal tract are all confirmed by the immunohistochemical method that sarcoma cells come from B lymphocyte [CD 20 (+), CD 45 RO(-), CK(-)].We consider that sex, age and clinical appearence are not valuable for the diagnosis of primary B cell lymphoma of gastrointestinal tract. The conventional pathologic method is helPFUl. However, for some cases that pathological features are not obvious it is necessary to combine immunohistochemical method to get a trustworthy diagnosis.