性腺弥漫大B细胞淋巴瘤十例临床病理分析

Clinicopathologic analysis of ten patients with gonadal diffuse large B-cell lymphoma

目的观察性腺弥漫大B细胞淋巴瘤（DLBCL）的临床病理及免疫表型特点，探讨其病理诊断方法及预后。方法回顾性分析10例性腺DLBCL患者临床病理资料，包括形态学、免疫组织化学，并复习相关文献。结果10例患者中9例为睾丸DLBCL，患者年龄40-85岁，中位年龄67岁；1例为卵巢DLBCL，年龄46岁。光学显微镜下可见肿瘤细胞中等大小或偏大，弥漫一致浸润性分布，睾丸肿瘤组织可见残留的曲细精管。Hans分型以非生发中心B细胞型（non-GCB型）为主（70%，7/10）。随访6-103个月，失访2例，患者1、3、5年生存例数分别为4、2、2例。结论原发性性腺DLBCL少见，多为non-GCB型，预后不佳，可采用手术及化疗等综合治疗，预后需多因素综合评价。

Objective To investigate the clinicopathologic characteristics, immunophenotype, differential diagnosis, and prognostic factors of gonadal diffuse large B-cell lymphoma （DLBCL）. Methods The clinicopathologic data of 10 patients with gonadal DLBCL including morphology and immunohistochemistry were analyzed retrospectively, then the literature was reviewed. Results Among 10 patients, 9 cases were testicular DLBCL, and the median age was 67 years old （40-85 years old）; 1 case was ovary DLBCL, and the age was 46 years old. Tumor cells were large to medium-sized under the optical microscope, which were characterized as diffuse infiltration around the duct and the remaining convoluted tubule of testis neoplasms. Most DLBCL （70 %, 7/10） immunophenotype analysis showed non-germinal center B-cell （non-GCB） type. Patients were followed up from 6 to 103 months, and 2 patients lost follow-up. The survival number of patients in 1-year, 3-year, and 5-year was 4, 2, 2 respectively. Conclusions Primary gonadal DLBCL is an uncommon extranodal lymphoma, which mainly belongs to non-GCB type with poor prognosis. Comprehensive treatments usually take operation and chemotherapy, and the prognosis should be evaluated by multiple factors.