儿童非霍奇金淋巴瘤195例临床病理分析

Clinical pathologic study of 195 cases of childhood non-Hodgkin's lymphoma

目的探讨儿童非霍奇金淋巴瘤(NHL)的临床病理特点。方法收集1982年1月—2010年1月诊断的非霍奇金淋巴瘤病例195例,进行临床和病理分析。结果儿童NHL发病年龄高峰在6～8岁,男女之比为2.3∶1,Ⅲ期和Ⅳ期占49.2%。病理组织类型主要有淋巴母细胞性淋巴瘤(LBL)、Burkitt淋巴瘤(BL)、间变性大细胞性淋巴瘤(ALCL);88.8%LBL为T细胞性淋巴瘤,BL皆为B细胞性淋巴瘤,ALCL皆为T细胞性淋巴瘤。37.9%病例首发于淋巴结外组织,56.1%LBL患儿确诊时已累及1个以上部位。结论儿童NHL的临床及病理表现与成人NHL存在很大差异。免疫组化等技术对NHL的病理诊断有重要作用。

Objective To evaluate the clinical and pathological features of childhood non-Hodgkin＇s lymphoma（NHL）.Methods A total of 195 NHL cases,with age younger than twelve years old,diagnosed from January 1982 to January 2010 in Xinhua Hospital were reviewed.Results The peak onset age is 6-8 years old.The male to female ratio is 2.3 ∶ 1 and male patients predominate in each subtype.The cases in stage Ⅲ and Ⅳ account for 49.2%.The most common subtypes were lymphoblastic lymphoma（LBL）,Burkitt lymphoma（BL）and anaplastic large cell lymphoma（ALCL）.About 88.8% cases of LBL is T-cell lymphoma while all the BL is B-cell lymphoma and all the ALCL is T-cell lymphoma.More than 1/3（37.9%）of all the cases have primary extranodal lymphoma.More than one organ involvement was found in 56.1% of LBL cases when they were diagnosed.Conclusions Childhood NHL differs greatly from adult NHL in clinical and pathological aspects.Immunohistochemistry plays an important role in diagnosis.