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目的探讨肾移植后淋巴组织增生性疾病(PTLD)的临床病理学特征,提高对该疾病的诊治水平。方法报道2例肾移植后PTLD,采用CD20、CD3、CD45RO、CD79a、bcl-6、CD10、Mum-1和Ki-67等抗体进行免疫组化染色,并进行EBV原位杂交检测,同时结合文献复习进行讨论。结果 2例患者肾移植术后均采用三联免疫抑制疗法,PTLD诊断时间分别为3年和16年。2例病理组织学类型均为单型性PTLD,其中1例为外周T细胞性淋巴瘤,1例为弥漫性大B细胞性淋巴瘤,均无特异性临床表现。确诊后均将免疫抑制剂减量,其中1例辅以利妥昔单抗治疗。1例患者确诊后短期内死亡,另1例患者生存。结论 PTLD是发生在器官移植后具有独特形态和临床特征的淋巴组织增生性疾病,预后较差,采用免疫抑制剂减量和抗利妥昔单抗治疗有效。
Objective To investigate the clinicopathological features of post-transplant lymphoproliferative diseases (PTLD) and to improve the diagnosis and treatment of this disease. Methods Two cases of PTLD after renal transplantation were reported. Immunohistochemical staining was performed using antibodies such as CD20, CD3, CD45RO, CD79a, bcl-6, CD10, Mum-1 and Ki-67. EBV in situ hybridization Review for discussion. Results Two patients were treated with triple immunosuppressive therapy after renal transplantation. The diagnosis time of PTLD was 3 years and 16 years respectively. Two cases of histopathological types were monotypic PTLD, including 1 case of peripheral T cell lymphoma, 1 case of diffuse large B cell lymphoma, no specific clinical manifestations. After the diagnosis of immunosuppressive agents will be reduced, of which 1 case supplemented with rituximab treatment. One patient died shortly after diagnosis and the other survived. Conclusions PTLD is a lymphoproliferative disease with unique morphology and clinical features that occurs after organ transplantation. The prognosis is poor. Immunosuppressive agents and anti-rituximab treatment are effective.