间变性大细胞淋巴瘤10例临床病理学观察

Obsevation of Clinicopathology on 10 cases of Anaplastic Large Cell Lymphoma

目的:探讨间变性大细胞淋巴瘤(anaplastic large cell lymphoma,ALCL)的病理形态、免疫表型特征及临床预后。方法:对10例ALCL进行形态学观察,免疫组化标记,并结合相关文献进行讨论。结果:本组ALCL男女之比为9:1,平均年龄38.7岁。发生部位包括颈部淋巴结4例,小肠2例,头皮2例,纵膈1例,支气管1例。ALCL形态表现多样,细胞呈多形性,大小不等,胞质丰富,细胞核大而不规则,呈扭曲、肾形、马蹄形及花环状,甚至见多核及瘤巨细胞。免疫表型:10例ALCL均阳性表达CD30,部分表达EMA、CD3和CD45RO,不表达AE1/AE3、CD20、HMB45、S100、CD68和CD15。结论:ALCL是一种少见的非霍奇金淋巴瘤,诊断依赖于组织病理学及免疫组化标记,应与霍奇金淋巴瘤、弥漫性大B细胞淋巴瘤、低分化癌、恶性黑色素瘤等进行鉴别。

Objective：Purpose To explore the histological immunohistochemical characters and prognosis of anaplastic large cell lymphoma （ALCL）. Methods Histology and immunohistochemical markers of 10 ALCL cases were analyzed and the correlated literature was reviewed. Results The ALCL of 10 patients had 9：1 male/fe-male ratio with an average age of 38.7. 4 cases were located in the lymph node of neck,2 in small intestine,2 in epicranium,1 in mediastina and 1 in bronchus.The ALCL showed distinctive morphological characters. The tumors were mainly composed of large and pleomorphic Cells with abundant cytoplasm. The nuclei were large and irregular with shape of twist horseshoed and wreath like. Multiple nuclei or huge nuclei were seen sometimes.All 10 eases expressed CD30 and partly expressed CD3,EMA and CD45RO.AI1 cases were negative for AEl/AE3,CD20,HMB45,S100,CD68,CD15. Conclusions ALCL is extremely rare. It is necessary to differentiate from other type of tumors such as the Hodgkin lymphoma, diffuse large B cell lymphoma, poor differentiated carcinomas and malignant melanoma.