前列腺原发性血管内大B细胞淋巴瘤临床病理特征分析

Primary intravascular large B-cell lymphoma of prostate:report of a case and review of literature

目的探讨前列腺原发性血管内大B细胞淋巴瘤(intravascular large B-cell lymphoma,IVLBCL)临床表现、病理学特征、诊断及鉴别诊断。方法对1例前列腺原发性IVLBCL行HE及免疫组化EnVision两步法染色,分析其临床病理学特征和免疫表型,并复习相关文献。结果镜下,前列腺间质血管内见异型淋巴样细胞,细胞核大而深染,可见突出核仁,核分裂象易见。免疫组化:肿瘤细胞CD20、MUM1、Bcl-2阳性,CD34显示瘤细胞生长在血管内。Ki-67增殖指数80%。患者术后未经化疗,随访6个月后死亡。结论前列腺原发性IVLBCL比较罕见,临床表现常不典型,易导致漏诊、误诊,确诊需结合病理形态学检查和免疫标记。

Objective To investigate the clinical features,pathological features,diagnosis,and differential diagnosis of primary intravascular large B-cell lymphoma(IVLBCL)of the prostate.Methods A case of primary intravascial large B-cell lymphoma in prostate was examined by HE and Elivision immunohistochemical two-step staining.The clinicopathological features and immunophenotype of the case were analyzed and the relevant literatures were reviewed.Results Under the microscope,atypical lymphoid cells were seen in the interstitial vessels of the prostate gland.The nuclei were large and dark stained,and there were prominent nucleoli.Immunophenotypically,tumor cells were positive for CD20,MUM1,and Bcl2,and CD34 showed tumor cells growing in blood vessels.Ki-67 proliferation index was 80%.The patient died after 6 months of follow-up without postoperative chemotherapy.Conclusion Intracavascular large B-cell lymphoma of primary prostatic disease is rare and its clinical manifestations are often atypical,which can easily lead to missed diagnosis and misdiagnosis.The diagnosis should be combined with pathomorphological examination and immunolabeling.