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目的探讨肝血管内大B细胞性淋巴瘤的临床病理特征、诊断与鉴别诊断、治疗及预后。方法回顾性分析2例肝血管内大B细胞性淋巴瘤患者的临床资料、组织病理学形态和免疫组化结果。结果光镜下肝窦内和小血管内可见较多具有明显异型性的淋巴样细胞浸润,汇管区可见慢性炎细胞浸润,亦可见少许异型淋巴细胞样细胞,未见明确纤维化。免疫组化示CD20、PAX5弥漫(+),CD3散在少许(+),Ki-67阳性率为70%,AE1/AE3、CD117和CD56均(-);其中例1 CD5弥漫(+)。结论血管内大B细胞性淋巴瘤是一种具有高度侵袭性的结外弥漫性大B细胞性淋巴瘤的亚型,由于该病临床表现多样及不典型性,造成了部分患者的诊断困难,因此,掌握临床病理及免疫组化特征对该病的诊断和鉴别诊断具有重要意义。
Objective To investigate the clinicopathological features, diagnosis, differential diagnosis, treatment and prognosis of intrahepatic major B-cell lymphoma. Methods The clinical data, histopathological features and immunohistochemical results of 2 patients with hepatocellular large B-cell lymphoma were retrospectively analyzed. Results There were more infiltrating lymphoid cells in the sinusoids and small vessels under the light microscope. Inflammatory cells could be seen in the portal area with a little infiltrating lymphocytes, and no definite fibrosis was observed. Immunohistochemistry showed CD20, PAX5 diffuse (+), CD3 scattered a little (+), Ki-67 positive rate was 70%, AE1 / AE3, CD117 and CD56 were (; Conclusion Intravascular large B-cell lymphoma is a subtype of highly invasive extra-diffused large B-cell lymphoma. Due to the diverse and atypical clinical manifestations of the disease, some patients have difficulty in diagnosis. Therefore, to master the clinicopathological and immunohistochemical features of the diagnosis and differential diagnosis of the disease is of great significance.