皮肤NK/T细胞淋巴瘤的临床病理及其与EB病毒关系的研究

Investigation of the Clinicopathologic Features of Cutaneous NK/T Cell Lymphoma and Epstein－ Barr Virus Infection

目的探讨皮肤 NK/T细胞淋巴瘤的临床病理特点、免疫表型及与 EB病毒感染的关系。方法应用免疫组织化学染色，选用 CD45RO、 CD3ε、 TIA－ 1、 CD20、 Ki－ B5、 CD68和 LMP1等抗体；用 EBER1/2原位杂交检测 EB病毒编码的小分子 RNA。结果 5例皮肤 NK/T细胞淋巴瘤患者占同期皮肤恶性淋巴瘤的 5.68％；男 4例，女 1例，平均年龄 34岁，主要表现为皮肤无症状肿块， 2例有溃疡形成；组织学特征为肿瘤在真皮和皮下脂肪内，易形成血管浸润性和破坏性病变，瘤细胞大小、形态各异；瘤细胞表达 T细胞标记（ 5/5）和 NK细胞或细胞毒性 T细胞标记 TIA－ 1（ 4/4）， EBER1/2（ 3/4）。结论皮肤 NK/T细胞淋巴瘤具有临床病理独特性，与 EB病毒感染有较强的相关性。

Objective To study the clinicopathologic features and immunophenotype of cutaneous NK/T cell lymphoma and the association with Esptein－ Barr virus (EBV) infection. Methods Five cases of cutaneous NK/T cell lymphoma were studied. Histologic sections of embedded tissues were immunohistochemically stained with CD45RO, CD3ε , TIA－ 1, CD20, Ki－ B5, CD68 and LMP1 antibodies, and in situ hybridization for EBV－ encoded small nuclear RNAs－ EBER1/2 was also carried out. Results Cutaneous NK/T cell lymphoma accounted for 5.68％ in the cutaneous malignant lymphoma in the same period of observation. There were 4 male and 1 female patients, and the mean age was 34 years. The main clinical manifestations were asymptomatic nodules and masses, which were accompanied by ulcers in 2 cases. Histologically, the tumors were mainly located in the dermis and subcutaneous adipose tissue, the infiltrated lymphoid cells were pleomorphic, and angiocentricity and angiodestruction were found in almost all cases. Immunohistochemical stain showed that five cases were T cell phenotype and the expression rate of TIA－ 1 was 100％ (4/4). The EBV was present in three of four cases by in situ hybridization. Conclusions Cutaneous NK/T cell lymphoma presents with unique and diagnostic clinicopathologic features, and is strongly associated with EBV.