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目的 :探讨皮下脂膜炎样T细胞淋巴瘤 (SPTCL)的基因诊断方法及病理特点。方法 :在组织学诊断的基础上 ,辅以免疫组织化学 ,并利用PCR技术检测石蜡切片标本IgH及TCRβ基因重排。 结果 :将 3例原考虑为结节性非化脓性脂膜炎的病例确诊为皮下脂膜炎样T细胞淋巴瘤。患者均为青壮年 ,起病较急 ,表现为皮下结节伴红斑 ,镜下见异型淋巴细胞浸润皮下脂肪组织间质 ,呈脂膜炎样改变 ,可见核碎裂、局灶性脂肪坏死及泡沫状组织细胞。免疫表型 :LCA + ,UCHL 1+ ,Mac387- ,TCR β基因重排 + ,IgH基因重排 -。 结论 :皮下脂膜炎样T细胞淋巴瘤具有较特殊的病理组织学特征 ,基因诊断等新技术手段是皮下脂膜炎样T细胞淋巴瘤鉴别诊断的有效方法
Objective: To investigate the genetic diagnosis and pathological features of subcutaneous panniculitis-like T-cell lymphoma (SPTCL). Methods : On the basis of histological diagnosis and immunohistochemistry, PCR was used to detect IgH and TCRβ gene rearrangements in paraffin-embedded specimens. RESULTS: Three cases of nodular pancreatitis were initially diagnosed as subcutaneous panniculitic T-cell lymphoma. All the patients were young adults with acute onset, manifested as subcutaneous nodules with erythema. Under the microscope, heterotypic lymphocytes infiltrated the subcutaneous adipose tissue and showed changes in panniculitis-like changes. Nuclear fragmentation and focal fatty necrosis were observed. Foamy tissue cells. Immunophenotypes: LCA +, UCHL 1+, Mac387-, TCR β gene rearrangement +, IgH gene rearrangement -. Conclusion: Subcutaneous panniculitis-like T-cell lymphoma has special histopathological features. New methods such as gene diagnosis are effective methods for differential diagnosis of subcutaneous panniculitis-like T-cell lymphoma.