原发于中枢神经系统的弥漫性大B细胞淋巴瘤临床病理特征

Clinicopathological characteristics of primary central nervous system large B cell lymphoma

目的探讨原发于中枢神经系统的弥漫性大B细胞淋巴瘤(PCNSL)的临床病理特点及鉴别诊断。方法对5例原发于中枢神经系统的弥漫性大B细胞淋巴瘤的临床病理学特点及免疫表型进行分析,并结合相关文献进行讨论。结果 5例临床表现不同,病变多发生在灰白质交界的额叶、颞叶等部位,病理类型均为弥漫性大B细胞淋巴瘤。肿瘤细胞中等偏大,不规则,泡状核,核仁明显,核分裂象常见。免疫组化染色显示肿瘤细胞CD20、CD79a(+),Ki-67增殖指数达70%。结论多数原发于中枢神经系统的淋巴瘤为弥漫性大B细胞淋巴瘤,其临床表现与其发生部位有关,病理形态学和免疫组化是诊断的重要方法。

Objective To analyze the clinicopathological features and differential diagnosis in primary central nervous system of diffuse large B-cell lymphoma.Methods The histological changes and immunohistochemical phenotypes were analyzed in six cases of primary central nervous system diffuse large B-cell lymphoma with the review of related literatures.Results The clinical manifestations were different in these 5 cases,and most tumors occurred in gray-white border of the frontal lobe,temporal lobe.These tumor cells were enlarged with pleomorphic,vesicular nuclei,prominent nucleoli,and multiple mitotic figures.By immunohistochemistry,neoplastic cell was positive for CD20,CD79a,with a high Ki-67 proliferation index.Conclusion Clinical manifestations are related to its location of primary central nervous system diffuse large B-cell lymphoma,and it is usually diagnozed by the pathological examination and immunophenotyping of biopsy.