眼睑套细胞淋巴瘤临床病理分析

Clinical pathology analysis on primary eyelid mantle cell lymphoma

目的探讨眼睑原发性套细胞淋巴瘤（mantlecelllymphoma，MCL）的临床病理学特点及免疫表型。方法应用影像学及组织病理学技术对1例眼睑原发性MCL进行研究，观察其影像学特征、病理组织学形态及免疫组化表型。结果MRI提示右眼眶下缘片状等T1等T2信号影，边界清楚，大小约2．4cm×0．9cm×0．6cm，增强扫描轻度均匀强化，肿物邻近眼球，眼外肌结构完整，未见明确骨质破坏；光镜示肿瘤细胞弥漫性增生，肿瘤细胞小至中等大，核型不规则，染色质中度稀疏，可见核分裂像；肿瘤组织中散在分布上皮样组织细胞以及玻璃样变性红染的血管壁。免疫组化示：CD20（＋），CD3（-），CD5（＋），CyclinD1（＋）。结论原发于眼睑部位的MCL非常罕见，影像学无特征性的表现，组织学形态表现独特，免疫组化标记有助于该病的诊断。

Objective To investigate the pathological characteristics and immune phenotypes of primary eyelid mantle cell lymphoma （MCL）. Methods Imaging and histopathology techniques were used to observe radiologieal features, pathological histology and immunohistochemical phenotype of primary eyelid MCL. Results MRI hinted the same T1 and T2 signal with clear boundaries and a light uniform enhancement by means of enhanced scan in right orbit. The volume of the tumor was about 2.4 cm × 0.9 cm× 0.6 cm. The tumor close to the eyeball and the extraocular muscle and bone structure was integrity. The diffuse proliferative tumor cells were small to medium large with irregular karyotype and sparse chromatin. Hyaline degenerated and red dyed vascular wall and epithelioid cells distributed in the tumor. The tumor cells were positively expressed CD20, CD3, CD5 and CyclinD1 protein. Conclusion Primary eyelid MCL is rare, which has a unique histological performance. Immunohistochemical markers can help the diagnosis of the disease.