原发于膀胱的血管内大B细胞性淋巴瘤临床病理观察

Intravascular large B-cell lymphoma of the urinary bladder: a case report and review of literature

目的探讨原发于膀胱的血管内大B细胞性淋巴瘤(IVLBCL)的临床病理特征及病理诊断。方法对1例原发于膀胱的IVLBCL进行组织学、免疫组化染色观察和随访。结果膀胱镜活检组织病理检查见肿瘤细胞在膀胱黏膜小血管内聚集。瘤细胞表现为弥漫一致的中等大细胞,胞质少,核大、深染。免疫组化结果显示肿瘤细胞CD20、CD79a和Mum-1均(+),Ki-67增殖指数为90%。CD3、CD5、CD30和CD10(-)。患者于确诊3个月后死亡。结论膀胱的血管内大B细胞性淋巴瘤极为罕见,预后较差。

Objective To study the clinicopathologic features and diagnosis of intravascular large B-cell lymphoma （IVLBCL）. Methods One case of primary urinary bladder IVLBCL was studied by microscopic observation, immunohistochemical staining and the clinical follow-up. Results Histopathological examination of cystoscopy specimens showed dissemination of abnormal lymphoma ceils within capillary lumens of bladder mucosa. The tumor cells showed diffuse monotonous medium-sized cells with marked hyperchromatism and high nuclear/cytoplasmic ratio. Immunohistochemical analysis showed that the these cells were positive for CD20, CD79a and Mum-l, and the positive rate of Ki-67 was 90%. while negative for CD3, CD5, CD30 and CD10. The patient died three months after diagnosis. Conclusions Primary malignant lymphoma of bladder is very rare. This is the first documented case of primary bladder involvement by intravascular large B-cell lymphoma.