肾移植后单形性T细胞型淋巴组织增生性疾病1例并文献复习

Post-renotransplant lymphoproliferative disorders: a case report and review of literature

目的 了解肾移植后淋巴组织增生性疾病 (PTLD)的病理形态及鉴别诊断。方法 对 1例肾移植后患者发生在右上肢皮下的PTLD进行大体、光镜、免疫组化观察并结合文献分析。结果 肿瘤镜下为弥漫分布小圆及卵圆形细胞 ,异型性明显 ,浸润皮下脂肪组织。免疫组化 :肿瘤细胞CD45RO、CD43、CD3和CD68(+) ;EBV、CD2 0、CD30和CD56(- )。结论 单形性T细胞型PTLD ,其发生与使用免疫抑制剂、EBV感染等多种因素有关 。

Objective To investigate the histopathological features and the differentiated diagnosis of posttransplant lymphoproliferative disorders (PTLD) Methods One case of PTLD in the right upper limb was analyzed with gross, light microscopic and immunohistochemical observation and the related literature was reviewed Results The tumor cells were small rounded or oval,with marked atypia, and infiltrated into adipose tissue Immunohistochemically, the tumor cells were positive for CD45RO, CD43, CD3, CD68, but negative for CD20,CD30,CD56,and EBV Conclusions The tumor is finally confirmed as T cell monomorphic PTLD by case history,histopathology,and immunohistochemistry The incidence of posttransplant lymphomas is markedly increased in recent years, and the tumor is associated with immunosuppressive treatment and EBV infection The prognosis was generally very poor