鼻型NK/T细胞淋巴瘤26例临床病理分析

Clinicopathological analysis of 26 cases of extra-nodal natural killer/T cell lymphoma of nasal type

目的:研究鼻型NK/T细胞淋巴瘤(ENKL)的免疫表型、病理特点、临床特点。方法:回顾性分析26例ENKL的临床表现、病理组织学特点,采用免疫组化SP法检测LCA、CD3、UCHL1、CD20、CD79a、CD56、TIA-1、Granzyme B、perforin,原位杂交方法检测EBER在ENKL中的表达情况。结果:NK/T细胞淋巴瘤发生在鼻腔占80.77%(21/26),伴坏死、溃疡、鼻出血者100%(26/26),肿瘤细胞嗜血管现象占46.15%(12/26),伴"鳞状细胞癌样反应"占20.08%(6/26)。CD3、CD56、TIA-1、Granzyme B、perforin及EBER阳性表达率达100%。结论:临床及病理形态复杂多样性是NK/T细胞淋巴瘤的特点。病理诊断中须注意与炎症或高分化鳞状细胞癌鉴别。ENKL根据典型的临床表现、病理形态学改变、免疫表型特点及EBER原位杂交阳性能准确诊断。

Objective：To improve the understanding of nasal NK/T cell lymphoma（ENKL） by analyzing its phenotypic and clinicopathological features.Methods：The clinical,pathologic features of twenty-six cases of ENKL were analysed restrospectively.Aantibodies of LCA,CD3,UCHL1,CD20,CD79a,CD56,TIA-1,Granzyme B and perforin were detected by immunohistochemical staining.EBER was detected by in situ hybridization.Results：80.77 %（21/26） of the nasal NK/Tcell lymphoma occurred in nasal cavity.All the 26 cases displayed necrosis,ulceration and nose bleeding,46.15%（12/26） showed angiodest ructive growth pattern,23.08 %（6/ 26） were accompanied by squamous cell carcinoma like epitheliomatous hyperplasia.The tumor cells had a typical phenotype：CD3＋,CD56＋,TIA-1＋,Granzyme B＋,perforin＋,EBER＋.Conclusion：Nasal NK/T cell lymphoma is characterized by multiple clinicopahtological features.Attention is needed to differentiate the tumor from inflammatory lesions and low grade squamous cell carcinoma.ENKL can be diagnosed via its typical clinical symptom,pathological morphology,phenotype and EBER detected by in situ hybridization.