肾移植后原发性渗出性淋巴瘤1例并文献复习

Primary Effusion Lymphoma after Renal Transplantation:a Case Report and Review of Literature

目的:对中国首例肾移植后同时伴有胸水及腹水的原发性渗出性淋巴瘤(primary effusion lymphoma,PEL)患者的临床资料及组织学特点进行分析。方法:采用细胞形态学、免疫组化以及分子病理学方法对PEL患者进行诊断,并结合文献进行讨论。结果:PEL细胞形态学特点为细胞呈散在分布,胞体大,胞核深染,核浆比增大,核分裂相易见,可见瘤细胞的多形性;免疫组化检测结果显示,PEL细胞中人疱疹病毒8型(human herpesvirus 8,HHV-8)、CD30、CD45、波形蛋白(vimentin)、上皮膜抗原(epithelial membrane antigen,EMA)等抗原呈阳性表达,而T细胞或B细胞抗原呈阴性;分子病理学检查发现,PEL细胞有单克隆性IgH基因及IgK基因重排。结论:了解PEL的病理及临床特点对其鉴别、诊断及治疗有重要意义。

Objective：To analyze the clinical datum and histologic features of the first case of recipient with primary effusion lymphoma （PEL） with both pleural fluid and ascites after renal transplantation in China. Methods：PEL patients were diagnosed by cytomorphology, immunocytochemistry and molecular pathology, and the related literatures were reviewed. Results： Cyto- morphology characteristics of PEL cells were large and scattered, with nuclear cytoplasmic ratio increased, and the mitotic rate was high. Immunohistochemisty results showed positive expression of antigens of human herpesvinus 8 （HHVS）, CD30, CD45, vimentin and epithelial membrane antigen（EMA） in PEL cells, whereas no immunophenotypic evidences of B- or T-cell antigens were found. Molecular pathological analysis showed a rearrangement of monoclonal gene IgH and lgK in PEL cells. Conclusions： Understanding the pathological and clinical characteristics of lymphoma enables a confident identification, diagno- sis and treatment for PEL.