肠道多发性淋巴瘤性息肉病2例报告

Intestinal Multiple Lymphomatous Polyposis: A Report of Two Cases

目的 探讨多发性淋巴瘤性息肉病 (MLP)的临床病理特征及诊断要点。方法 对 2例肠道MLP的临床表现 ,病理组织学观察及免疫组化S P法标记进行分析。结果 2例均为 5 0余岁男性 ,因便血作内镜检查 ,巨检发现肠粘膜多处息肉样肿块 ,直径 0 4～ 4cm。组织学瘤细胞为一致性小淋巴细胞与小裂细胞之间的形态 ,围绕滤泡中心生长 ,致使大部分滤泡破坏消失。肿瘤局限于粘膜固有层及粘膜下层 ,不形成淋巴上皮病损。免疫组化 :CD2 0、CD74、CD5阳性 ,单轻链λ表达。结论 MLP是极罕见的胃肠道淋巴瘤 ,属套细胞淋巴瘤 ,看似分化良好 。

Objective To study the clinicopathological features and diagnostic criteria of multiple lymphomatous polyposis (MLP). Methods Clinical presentations, histopathology and immunohistochemistry of MLP were analyzed in 2 cases. Results Two male patients were in their sixties. There were multiple polyps ( diameter from 0.4cm to 4 cm) in the intestinal mucosa on gross examination. Histologically, the tumor cells, which sizes were between small lymphocyte and small cleaved lymphoid cells, surrounded the germinal centers leading to atrophy or destruction of the most of them. The lesions were often limited in lamina propria and submucosa without lymphoepithelial lesions. Immunohistochemical stainings showed CD20+, CD74+, CD5+ and Igλ light chain restriction in the lymphoid cells. Conclusion MLP, as one of mantle cell lymphomas, was rare in the gastrointestinal tract. In spite of “low grade” morphology, its prognosis was very poor.