肺原发性间变性大细胞淋巴瘤1例及文献复习

One case of primary pulmonary anaplastic larger cell lymphoma and literature review

目的探讨肺原发性间变性大细胞淋巴瘤（anaplastic large cell lymphoma，ALCL）临床病理特点、免疫组化特点、鉴别诊断、治疗和诊断技术，以提高对肺原发性ALCL的认识。方法通过本病例及复习相关的文献资料，回顾性分析病例的临床特征、组织细胞形态学和免疫组化特点。结果肺原发性ALCL的临床特点以咳嗽、咯痰、胸痛伴气促为主，病变多发生于较大的支气管。组织、细胞形态学见瘤细胞体积较大，核多形性明显。免疫组化示肺原发性ALCL表达T细胞抗原、CD30及ALK（＋）。结论肺原发性ALCL非常罕见，其临床表现、影像学检查无特异性，容易误诊，而诊断需要依靠病理活检和免疫组化，该病预后较差。

Objective To investigate the clinical pathological features, immunohistochemical characteristics, differential diagnosis,treatment and diagnosis of primary pulmonary anaplastic larger cell lymphoma,so as to improve the understanding of this disease. Methods The clinical features,histiocygtic morphology and immunohistochemical characteristics of primary pulmonary anaplastic larger cell lymphoma were retrospectively analysed by studying one case and correlated literatures. Results Clinical features of primary pulmonary anaplastic larger cell lymphoma were mainly cough, sputum, chest pains combined with shortness of breath. The lesions often happened at larger bronchus. The malignant cells were obviously large and multinucleate. Primary pulmonary anaplastic larger cell lymphoma expressed T cell antigens,CD30（＋） and ALK（＋）. Conclusions Primary pulmonary anaplastic larger cell lymphoma is very rare. Clinical manifestations and radiological images are nonspecific,it is easy to be misdiagnosed. Its diagnosis bases on histopathology and immunohistochemistry. The prognosis of this disease is poor.