肺血管内大B细胞淋巴瘤一例分析并文献复习

Case report and literature review of intravascular lymphoma through lung biopsy

为了探讨血管内大B细胞淋巴瘤(IVLBCL)的临床和病理特点,分析1例IVLBCL的临床特征和病理资料,用形态学方法和免疫组化染色进行研究。系统分析国内公开报道24例IVLBCL临床表现及诊断特点。本例临床表现以呼吸系统症状为主,肿瘤通过肺活检发现,镜下表现瘤细胞仅位于小血管腔内,瘤细胞大,核仁明显。瘤细胞表达淋巴细胞标记LCA(+),CD20(+),CD79a(+),CD3(-),CD45RO(-),血管内皮CD31(+),CD34(+)。初步研究结果提示,我国IVLBCL具有自身特点,该瘤是一种罕见的结外弥漫性大B细胞淋巴瘤,诊断只能依靠病理检查确诊,发热气喘等呼吸系统症状具有提示作用。该瘤具有高度恶性和高度侵袭性,预后很差,早期诊断具有重要意义。

The objective of this study was to investigate the clinical and pathological features of intravascular large B cell lymphoma（IVLBCL）.To report a case of intravascular lymphomatosis with primary pulmonary lesion where an early diagnosis was obtained through needle biopsy lung biopsy.HE staining and immunohistological staining were analyzed,further finished a systems review of 24 cases Chinese IVLBCL.This case present major clinical symptom included fever,cough,dyspnea.The transbronchial lung biopsy pathology diagnosed intravascular lymphoma.The immunophenotypic features were LCA（＋）,CD20（＋）,CD79a（＋）,CD3（-）,CD45RO（-）,CD31（＋）,CD34（＋）.In conclusion,intravascular lymphoma is a rare disease characterized by exclusive or predominant growth of neoplastic cells within the small blood vessels.In Chinese patient,lung involvement seems to be common distinct from Japanese and European.It is thought that lung biopsy could be a useful procedure for early and reliable diagnosis of primary pulmonary intravascular lymphomatosis and that it might contribute to an improved prognosis.