结节硬化性霍奇金淋巴瘤临床病理分析并文献复习

Clinicopathologic Analysis of Nodular Sclerosing Hodgkin Lymphoma and Literature Review

目的探讨结节硬化性霍奇金淋巴瘤的临床病理学特点及诊断要点。方法对3例结节硬化性霍奇金淋巴瘤的临床资料、病理形态学进行观察,并结合文献对其诊断及鉴别诊断进行探讨。结果 3例镜下均可见宽大的胶原带将淋巴组织分隔成多结节状;淋巴组织中瘤细胞异型性明显,可见瘤巨细胞,间质胶原化,也可见镜影细胞,背景中见嗜酸粒细胞及中性粒细胞,核分裂象易见;免疫组化示3例CD30表达阳性,其中2例CD15和CD20均表达阳性,1例CD20表达阳性,但CD15表达阴性。病理诊断为结节硬化性霍奇金淋巴瘤。结论结节硬化性霍奇金淋巴瘤临床少见,易误诊,应提高对该病的认识。

Objective To explore the clinicopathologic characteristics and diagnostic criteria of nodular sclerosing Hodgkin lymphoma. Methods The clinical data and pathomorphology of 3 patients with nodular sclerosing Hodgkin lymphoma were observed,and diagnosis and differential diagnoses combined with the literature were also analyzed. Results Microscopic examination in the 3 patients showed that a generous collagen separated lymphoid tissues into multi nodules; pleomorphism of tumor cells in the lymphoid tissues were significant,and tumor giant cells were visible and interstitial collagen,and mirror image cells were also visible,eosinophils and neutrophils were seen in the background,and nuclear mitotic figures were easy to see. Immunohistochemical staining showed that 3 patients were tested positive for CD30,two of whom were tested positive for CD15 and CD20,and the other one was tested positive for CD30 and CD20 and negative for CD15. Pathological diagnosis turned out to nodular sclerosing Hodgkin lymphoma. Conclusion Nodular sclerosing Hodgkin lymphoma is rare and tends to easily confused with other tumors,therefore it is essential to enhance awareness of the disease.