套细胞淋巴瘤临床病理特征及免疫表型分析

Clinicopathologic features and immuonphenotyping of mantle cell lymphoma:a study of 126 cases

目的探讨套细胞淋巴瘤(MCL)临床病理特征及免疫表型特点,旨在提高对其的认识。方法回顾性分析2000-01—2011-12间广州医学院第二附属医院、中山大学附属第一、三医院和肿瘤医院诊断的MCL126例,分析其临床病理特点。采用EnVision法对11种抗原标记物进行检测。结果 MCL共126例,男性95例,女性31例,男女之比为3.06:1,中位年龄53岁(34～80岁)。发病部位以淋巴结最多(80例),结外以胃肠道(20例)及扁桃体多见(12例)。临床分期为Ⅱ期2例,Ⅲ期58例,Ⅳ期66例。从组织结构上看,套区型3例,结节型5例,弥漫型118例。从细胞形态上看,经典型114例,小细胞型4例,多形性3例,单核样B细胞型2例,母细胞样变异型2例,伴浆细胞样分化型1例。免疫组化显示B细胞抗原(+),并且以CD5、cyclinD1和SOX11(+)为特征。结论 MCL以中老年男性多见,大多数发生于淋巴结内,临床分期高、预后差,组织形态学及免疫组化对诊断MCL具有重要价值。

Objective To explore the clinicopathologic features of mantle cell lymphoma and to improve the recognition of mantle cell lymphoma. Methods Cases diagnosed as mantle cell lymphoma between January 2000 to December 2011 were analysed retrospectively from The Department of Pathology, the Second Affiliated Hospital of Guangzhou Medical College and the First Affiliated Hospital, the Third Affiliated Hospital and Cancer Center of Sun-yat Sen University. All cases were studied by immunohistochemical staining using a panel of antibodies. Results There were 126 cases of mantle cell lymphoma including 95 cases of males and 31 cases of females, the ratio of male to female was 3.06： 1. The median age was 53 years with a range from 34 years to 80 years. The most common site was lymph nodes （80 cases） and extranodal sites including gastroinstestinal tract and tonsil, which were 20 cases and 12 cases, respectively. Two cases were in stage II , 58 cases in stage llI, and 66 cases in stage IV according to Ann Arbor clinic stage. Histopathologically, 3 cases of mantle zone pattern, 5 cases of nodular pattern and 118 cases of diffuse proliferative pattern. Cytologically, 114 cases of classic type, 4 cases of small cell type, 3 cases of pleomorphie type, 2 cases of monocyoid B cell, 2 cases of blastoid and one case with plasmacytoid differentiation. All cases were positive for B-cell antigen and CD5, cyclinD1 and SOX11. Conclusions Mantle cell lymphoma most commonly occurs in elderly men, mostly locates within lymph node with advanced clinical stage, and the prognosis is poor. Morphology and immunohistochemieal staining are very useful in the diagnosis of mantle cell lymphoma.