灰区淋巴瘤2例临床病理分析

Grey zone lymphoma(GZL):report of 2 cases

目的:探讨灰区淋巴瘤(grey zone lymphoma,GZL)的临床和病理组织学特征。方法:应用光镜观察及免疫组化染色对2例GZL患者的病理标本进行分析,同时复习相关文献。结果:例1患者经右锁骨上淋巴结活检,其肿瘤病理组织学形态类似经典型霍奇金淋巴瘤(classic Hodgkin's lymphoma,CHL),但肿瘤细胞免疫表型为CD30+、CD15-、CD20+。例2患者为纵隔肿瘤,肿块主要表现为弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLB-CL),肿块边缘灶区分布霍奇金细胞和RS(Hodgkin's and Reed-Sternberg,HRS)样细胞,这些细胞呈CD30+、CD15+、部分CD20+、CD79α+、BOB.1+、OCT2-,同时部分HRS样细胞呈EBV+。结论:本研究的2例GZL患者在组织学形态和免疫学表型上同时具有CHL和DLBCL的共同特点,预后较差。

Objective To study the clinical and pathological features of grey zone lymphoma （GZL）. Methods Two cases of GZL were described. Their clinical data,pathologic characteristics and immune-phenotype were analyzed. Results Case 1 had a biopsy obtained from fight supraelavieular lymph node, the histological features were similar to classic Hodgkin＇s lymphoma（CHL）, but the immuno-phenotype of tumor cells showed CD30＋, CD15-, CD20＋. Case 2 had an anterior mediastinal mass which showed a diffuse large B-cell lymphoma （DLBCL） with pleomorphic cytology and the presence of Hodgkin＇s Reed-Sternberg and lacunar cells. Immuno-phenotypically, the Reed-Steruberg and lacunar cells expressed CD30, CD15, CD20, CD79α, OCT2 and BOB.I; Epstein-Barr virus protein was expressed in part of the Hodgkin＇s Reed-Sternberg and lacunar cells. Conclusins The two GZL reported have a mixed feature of CHL and DL- BCL, and the prognosis are poor.