原发性中枢神经系统恶性淋巴瘤临床病理分析(附10例报告)

Clinicopathological Analysis of Primary Malignant Lymphoma in Central Nervous System(A Report of10Cases)

目的探讨原发性中枢神经系统恶性肿瘤的临床病理特点、诊断及鉴别诊断。方法对10例原发性中枢神经系统恶性淋巴瘤进行临床资料分析及光镜和免疫组化研究。结果临床上以颅内压高为主要症状。组织学特征:瘤细胞单一、异型、围绕血管呈套袖样排列,无滤泡形成。免疫组化:LCA,CD20或CD43阳性,CK,GFAP阴性,提示多为B细胞性。结论原发性中枢神经系统恶性淋巴瘤有其独特的临床病理特点,需与其他颅内小圆形细胞肿瘤鉴别,光镜结合免疫组化染色可以确诊。

Objective To explore the clinicopathological features,diagnosis and differential diagnosis of the primary central nervous system malignant lymphoma(PCNS-ML).Methods The clinical data of10patients with PCNS-ML were analyzed retrospectively.Their pathology was studied by light microscope and immunohistochemistry in which monoclonal antibodies against LCA,CD20,CD43,CK and GFAP were used.Results The main symptoms were caused by intracranial hypertension.Histologically,the tumor cells were heteromorphic and spreaded around the vessels,and no follicles were formed in the PCNS-ML.The immunohisto-chemical examination showed that in all the tumor cells LCA,and CD20or CD43were positive,and CK,GFAP were negative.It was suggested that most of the PCNS-ML were derived from B cells.Conclusions The PCNS-ML has the distinct clinicopathological features.The differential diagnosis should be made between this tumor and the other intracranial tumors of small and round cells.Its diagnosis mainly relies on light microscope and immunohistochemistry examination.