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目的总结原发性乳腺淋巴瘤(primary breast lymphoma,PBL)的临床病理学、免疫组织化学特征、综合治疗及复发情况。方法对2010年11月入院手术切除的PBL术后同侧乳头复发的1例患者的临床资料进行回顾分析,病理常规切片及免疫组织化学观察。结果光学显微镜检查低倍镜下肿瘤细胞弥漫性浸润破坏乳头组织,导致乳头结构紊乱,肿块乳管结构紊乱;高倍镜下显示瘤细胞成分多样,以中等大小细胞和大细胞为主,肿瘤细胞弥漫侵犯小血管。免疫组织化学结果显示Ki-67(>90%),CD20(+),bcl-6(+),MUM1(+),CD43(灶+),CD3(-),CD10(-)。符合恶性非霍奇金淋巴瘤。结论 PBL是一种少见的结外淋巴瘤,临床表现缺乏特异性,术前很难与乳腺其他良、恶性病变区分,其诊断主要依靠术后病理。目前单纯肿块切除术+放射治疗联合全身化学疗法是治疗PBL临床共识,肿瘤复发可能与Ki-67高度表达存在相关性。
Objective To summarize the clinicopathological, immunohistochemical characteristics, comprehensive treatment and relapse of primary breast lymphoma (PBL). Methods The clinical data of 1 patient with ipsilateral papillary recurrence after PBL resection in November 2010 were retrospectively analyzed. The pathological sections and immunohistochemistry were performed. Results Microscopic examination revealed diffuse infiltration of tumor cells in the papillary tissue under low magnification, which resulted in disorganization of the nipple structure and disruption of the structure of the ducts of the lumps. The tumor cells were mainly composed of medium and large cells under high magnification, and the tumor cells were diffuse Infringe on small blood vessels. Immunohistochemistry showed Ki-67 (> 90%), CD20 (+), bcl-6 (+), MUM1 (+), CD43 (CD +), CD3 (-) and CD10 (-). In line with the malignant non-Hodgkin's lymphoma. Conclusion PBL is a rare extranodal lymphoma, the clinical manifestations of the lack of specificity, it is difficult to distinguish preoperative and other benign and malignant lesions of the breast, the diagnosis depends mainly on postoperative pathology. At present, simple lump resection combined with radiotherapy combined with systemic chemotherapy is the clinical consensus of treatment of PBL, tumor recurrence may be related to the high expression of Ki-67.