CD30阳性的窦性大B细胞淋巴瘤临床病理学分析

A clinicopathologic study of CD30-positive sinusoidal large B-cell lymphoma

目的 探讨CD30阳性的窦性大B细胞淋巴瘤 (SLBCL)的临床病理学特征及其与Epstei Barr(EB)病毒的关系。方法 结合临床特点、形态学及免疫表型分析 ,并通过聚合酶链反应 (PCR)法检测EB病毒BamHIWDNA片段及免疫组织化学法检测潜伏膜蛋白 1(LMP1) ,对 2例CD30阳性的SLBCL进行分析。结果 2例分别为 6 4岁男性及 85岁女性 ,均表现为浅表淋巴结肿大 ,其中 1例 10个月后死于肿瘤。镜下 ,肿瘤都以窦性分布且彼此黏附的生长方式及相对单形的细胞形态为特征。免疫表型分析提示 ,两者均呈CD4 5、CD30、CD2 0或CD79α阳性而不表达上皮膜抗原 (EMA)、ALK1及组织细胞或T细胞的标志。未发现 2例有EB病毒感染的证据。结论 CD30阳性的SLBCL是一种形态、表型独特的弥漫大B细胞淋巴瘤变异类型 ,该瘤需与T/裸细胞性间变性大细胞淋巴瘤及其他一些累及淋巴窦为主的淋巴结病变相鉴别 ,但与EB病毒可能无关。

Objective To explore the clinicopathologic features of CD30 positive sinusoidal large B cell lymphoma (CD30+ SLBCL) and its relative correlation with Epstein Barr virus(EBV). Methods Two cases of CD30+ SLBCL, a65 year old men and a 85 year old women were morphologically and immunophenotypically analyzed. EBV status was also evaluated through not only the polymerase chain reaction (PCR) amplification to the EBV Bam HIW DNA sequence, but also an immunohistochemical detection of the latent membrane protein 1 (LMP1). Results The patients presented with similarly superficial lymphadenopathy . One of them died of the tumor within 10 months. Microscopically, both of the neoplasms were characterized by a cohesive sinus growth pattern and the monomorphic cytology of the tumor cells. Immunohistochemically, They were both positive for CD45, CD30, and CD20 or CD79α, whereas neither expressed EMA, ALK1, nor any histiocytic/T lineage markers. No evidence of EBV infection could be found either. Conclusions CD30+ SLBCL is a morphologically and immunophenotypically distinctive variant of diffuse large B cell lymphoma, which should be distinguished from T/null cell type anaplastic large cell lymphoma and some other nodal lesions with a predominantly sinusoidal infiltrative pattern. CD30+ SLBCL may not be correlation with EBV.