血管免疫母细胞性T细胞淋巴瘤免疫表型及临床病理分析

Clinical and pathological analysis of angioimmunoblastic T-cell lymphoma

目的:探讨血管免疫母细胞性T细胞淋巴瘤的诊断及鉴别诊断。方法:应用组织病理学及免疫组织化学观察28例血管免疫母细胞性T细胞淋巴瘤的特点,并结合文献探讨其病理形态及鉴别诊断等。结果:镜检淋巴结内可见多形性的小到中等大小的淋巴细胞,胞浆透明,核圆形或卵圆形,有小的核仁。可见散在的免疫母细胞样的大细胞,高内皮静脉和滤泡树突网的明显增生,伴有炎性反应性的背景。免疫组化显示肿瘤细胞特异性的表达CD10、Bcl-6、CXCL13,并伴有CD21、CD35阳性的滤泡树突网增生,大的免疫母细胞表达CD20、CD79a及LMP1。结论:血管免疫母细胞性T细胞淋巴瘤形态学上表现为淋巴结多形性T细胞浸润、滤泡树突细胞的增生、高内皮静脉增生和多克隆性的B细胞增生。CD10、Bcl-6、CXCL13对于确诊有重要意义。

Objective：To investigate the diagnosis and differential diagnosis of angioimmunoblastic T - cell lym- phoma. Methods ：To observe the feature of 28 cases of angioimmunoblastic T- cell lymphoma by histopathologic and immunohistochemistric methods, and investigate the pathological features and differential diagnosis of angioimmuno- blastic T - cell lymphoma combining with the literatures. Results： Microscopy showed small to medium - sized lym- phoeytes in lymph nodes, cytoplasm transparent, nucleus round or oval, small nucleoli, and scattered immunoblastic like ceils, obvious proliferation of high endothelial venules and follicular dendritic network, accompanied by inflamma- tory reactions background. Immunohistochemistry showed tumor cell specific expression of CD10, Bcl - 6, CXCL13, as- sociated with CD21 and CD35 positive foUieular dendritic network hyperplasia, large immunoblastic expression of CD20,CD79a, LMP1. Condtlsion： Angioimmunoblastic T- cell lymphoma morphology manifested as lymph nodes pleomorphic T cell infiltration, follicular dendritic cell and high endothelial venules proliferation, polyclonal B cell pro- liferation. CDI0, Bcl -6, CXCL13 are important immune markers for diagnosis of angioimmunoblastic T - cell lympho- ma.