CD5阳性的弥漫性大B细胞淋巴瘤临床病理分析

Clinicopathologic analysis CD5-positive diffuse large B-cell lymphoma

目的 探讨CD5阳性的弥漫性大B细胞淋巴瘤（diffuse large B cell lymphoma,DLBCL）的临床病理特征及临床预后意义.方法 分析13例CD5阳性的DLBCL的临床资料、组织学特点、免疫表型及临床随访资料,并复习相关文献.结果 13例DLBCL组织CD5抗原阳性,阳性反应定位于肿瘤细胞膜,全部表达B系列抗原CD20、CD79a.组织学特征：9例为中心母细胞变异型,2例为免疫母细胞变异型,2例为间变型.治疗方案选用R-CHOP,其中7例完全缓解,2例部分缓解,1例进展;另3例未选择治疗.随访4 ～46个月,3例死亡,9例情况良好,1例失访.结论 CD5阳性的DLBCL临床少见,老人多发,其分期高、预后不良,亟需探寻新的治疗方法延长患者的生存期.

Purpose To explore the clinical and pathological characteristics and clinical prognostic significance of CD5-positive diffuse large B-cell lymphoma （DLBCL）.Methods 13 cases of CD5-positive DLBCL patients with clinical data,histological features,immunohistochemical staining results and clinical follow-up were analysed,the related literatures were reviewed.Results All 13 cases of CD5-positive DLBCL were also positive for pan B cell antigen （CD20,CD79a）.Histologically,9 cases were centroblastic cell variant,2 cases were immunoblastic variant,2 cases were anaplastic variant.R-CHOP treatment program was selected,7 cases were complete remission,partial remission in 2 cases,progression in 1 case,3 cases untreated.After 4 ～ 46 months follow-up,3 patients died,9 cases were well,1 was lost.Conclusions CD5-positive DLBCL are rare with a higher age and poor prognosis,which need new treatments to prolong the patient＇s life.