原发性脑内淋巴瘤临床病理、免疫组化、基因重排分析

Primary malignant lymphoma of the brain : a clinicopathological, immunohistochemical and gene rearrangement study of 6 cases

目的 :研究脑内原发性恶性淋巴瘤临床病理、免疫组化及克隆性基因重排特征。方法 :对 6例脑原发性恶性淋巴瘤作了临床病理形态观察和免疫组化分析 (S P法 ) ,并用PCR技术单轮及半巢式扩增法进行IgH及TCR β基因重排检测。结果 :6例皆为非霍奇金B细胞淋巴瘤。瘤细胞大部分是中心或中心母细胞型 ,常伴浆样分化 ,往往围绕血管排列。PCR克隆性基因重排 ,IgH单轮法 (2 / 6例 )阳性 ,半巢式 (6 / 6例 )阳性 ,TCR β皆为阴性。结论 :脑淋巴瘤有其独特的临床病理特征。免疫组化及基因重排是诊断脑淋巴瘤重要工具。基因重排半巢式比单轮法优越 。

Purpose To study clinicopathological, immunohistochemical and clonality characteristics of primary malignant lymphoma of the brain.(PMLB). Methods Six cases of PMLB were investigated in terms of clinicopathology, immunohistochemistry (SP method), single and semi nested PCR technigue for IgH, TCR β gene rearrangement. Results All 6 cases were non Hodgkins B cell type lymphoma composed of centrocytic/centroblastic like cells. It was often accompanied with plasmoid differentiation and a vasocentric growth pattern. Gene rearrangement study demonstrated that with the single method only 2 cases showed positive amplification of clonal IgH and none of them showed positive amplification of TCR. With the semi nested technique all of them showed positive amplification of IgH. Conclusion The brain lymphoma has a distinct clinicopathological appearance. Immunohistochemistry and gene rearrangement are important detective methods for brain lymphoma diagnosis. The semi nested technique is more productive than single method. Its positive rates were high.