儿童淋巴瘤75例临床病理分析

Clinicopathological Analysis of 75 Cases of Childhood Lymphoma

目的探讨儿童淋巴瘤的临床和病理特点。方法收集1996年-2009年75例淋巴瘤患儿临床病理资料,进行光镜观察、免疫组织化学染色分析,对初步诊断为伯基特淋巴瘤和弥散大B细胞淋巴瘤的病例进行c-myc基因荧光原位杂交检测。根据WHO 2008年淋巴组织肿瘤分类标准进行分类。结果 75例儿童淋巴瘤中男57例,女18例,男女之比为3.171。发病平均年龄8.74岁。发病部位:淋巴结内32例(42.7%);淋巴结外43例(57.3%),以胃肠道(29.3%)为主。组织类型包括:霍奇金淋巴瘤13例(17.3%),淋巴母细胞淋巴瘤16例(21.3%),间变性大细胞淋巴瘤12例(16.0%),伯基特淋巴瘤和弥散大B细胞淋巴瘤33例(44.0%),小淋巴细胞性淋巴瘤1例(1.3%)。对初步诊断为伯基特淋巴瘤和弥散大B细胞淋巴瘤病例进行荧光原位杂交检测进行进一步诊断,结果显示,该组28例中存在c-myc基因改变者18例。结论儿童淋巴瘤以男性多见,发病部位以淋巴结和胃肠道多见。最常见的组织学类型依次为伯基特淋巴瘤、淋巴母细胞淋巴瘤、霍奇金淋巴瘤、间变性大细胞淋巴瘤和弥散大B细胞淋巴瘤。

Objective To analyze the clinicopathological features of childhood lymphoma. Methods Seventy - five cases of childhood lymphoma were selected from the files in period of 1996 to 2009 year. Pathologic diagnosis and immunophenotype analysis were performed according to the WHO classification for tumors of hematopoietic and lymphoid tissue （2008）. Fluorescence in situ hybridization （FISH） were used for detection of the segregation of c - myc gene in Burkitt lymphoma tumor and diffuse large B - cell lymphoma tumor. Results There were 57 cases of male and 18 cases of female in 75 cases of childhood lymphoma, the ration of sex was 3.17 ： 1, the average age was 8.74 years old. There were 32 cases （42.7%） in lymph node ,43 cases （57.3 % ） in extra - node, there were more cases （29.3 % ） in gastrointes- tinal tract. The most common subtypes were Hodgkin lymphoma （ 13 cases, 17.3 % ）, lymphoblastic lymphoma （ 16 cases,21.3 % ）, anaplastic large cell lymphoma （12 cases, 16.0% ）, Burkitt lymphoma and diffuse large B -cell lymphoma （33 cases ,44.0% ）, small lymphocytic lym- phoma（ 1 case, 1.3% ）. The genetic change of c - myc gene was executived by FISH in cases of Burkitt lymphoma tumor and diffuse large B - cell lymphoma tumor. Eighteen cases of Burkitt lymphoma tumor existed the c - myc gene segregation in 28 cases of Burkitt lymphoma and diffuse large B - cell lymphoma. Conclusions These cases of male are more than those of female. There are more cases in lymph node and gastrointestinal tract. The most common subtypes are Burkitt lymphoma, lymphoblastie lymphoma, Hodgkin lymphoma, anaplastic large cell lymphoma and diffuse large B - eel/lymphoma.