淋巴细胞管内聚集9例临床病理分析

Clinicopathological analysis of 9 cases of lymphocytes accumulation in tubes

目的探讨淋巴细胞管内聚集病变的临床病理特征、诊断及鉴别诊断。方法采用免疫组化Ventana Bench Mark法对9例淋巴细胞管内聚集病变进行检测,并进行随访。结果 9例病变发生部位:扁桃体4例,咽部2例,乳腺2例,十二指肠黏膜1例。病程2周~2个月,随访4~78个月,均未见复发。除十二指肠为息肉状,其他均为扁平隆起状病变,组织学表现为上皮下可见淋巴细胞聚集,充满多个淋巴管管腔,淋巴管周围血管增生明显,周围间质可见明显纤维化结构。免疫表型:T淋巴细胞标志物CD3、CD5、CD43弥漫强阳性,CD4、CD8部分细胞阳性,B淋巴细胞标志物显示散在分布细胞呈CD20阳性,判定为阴性。结论淋巴管内多量淋巴细胞聚集显示为一种良性的淋巴细胞增生病变,以慢性炎症改变、间质纤维化可能导致的局部淋巴导管受压、淋巴细胞腔内潴留;组织学形态类似于脉管内淋巴瘤表现,呈现单一、弥漫的T淋巴细胞免疫组化结果,但细胞不具有异型性,且临床症状表现为孤立的炎性改变,无明显恶性生物学行为。

Objective To investigate the clinicopathological characteristics,diagnosis and differential diagnosis of lymphocyte aggregation lesions.Methods The immunohistochemical Ventana Bench Mark method was used to detect 9 cases of lymphocyte aggregation lesions and follow up closely.Results 9 cases of lesion sites:4 cases of tonsils,2 cases of pharynx,2 cases of breast,1 case of duodenal mucosa.The course of the disease was 2 weeks to 2 months,and the follow-up was 4 to 78 months.No recurrence was found.Except for the duodenum,which was polyp-like,the others were flat and raised lesions.The histology showed that lymphocytes were gathered under the epithelium and filled In the lumen of each lymphatic vessel,the blood vessels around the lymphatic vessel proliferate obviously,and the surrounding interstitium has obvious fibrotic structure.Immunophenotype:T lymphocyte markers CD3,CD5,CD43 diffuse and strong positive,CD4,CD8 partial cells are positive,B lymphocyte markers show scattered cells are CD20 positive,judged as negative.Conclusion The accumulation of a large number of lymphocytes in the lymphatic vessels shows a benign lymphocytic proliferation disease,with chronic inflammation and interstitial fibrosis,which may lead to local lymphatic duct compression and lymphocyte retention;the histology is similar to intravascular lymph The tumor showed a single and diffuse T lymphocyte immunohistochemical results,but the cells did not have atypical characteristics,and the patient’s clinical symptoms showed isolated inflammatory changes without obvious malignant biological behavior.This performance is conducive to differential diagnosis.