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目的:探讨梅州地区胃肠道B细胞淋巴瘤的临床特征、分类特点及病理诊断。方法:对120例胃肠道原发B细胞淋巴瘤的临床资料、组织学形态、免疫表型进行分析,内容包括:患者年龄、性别、发病部位、内镜表现或手术切除大体形态、组织学形态、免疫组织化学(En Vision法)进行CD20、CD2、CD5、Bcl2、Bcl6、CD10、Cyclin-D1、Mum-1、Ki67染色。结果:患者年龄2.5-95岁(中位年龄52岁),男女比为1.2∶1;发病部位位于胃61例(50.83%),小肠16例(13.33%),回盲部4例(3.33%),盲肠15例(12.50%),结肠18例(15.00%),直肠6例(5.00%);内镜表现或手术切除标本呈息肉/结节/菜花状27例(22.50%),糜烂18例(15.00%),溃疡75例(62.50%);病理分类DLBCL 59例(49.17%),MALT 43例(35.83%),MCL10例(8.33%),Burkitt淋巴瘤7例(5.83%),FL 1例(0.83%);所有病例均表达CD20、不表达CD2,不同程度表达CD5、Bcl2、Bcl6、CD10、Cyclin-D1、Mum-1、Ki67。结论:梅州地区胃肠道B细胞淋巴瘤男性发病略高于女性(男女比为1.2∶1),胃肠发病比例差异不明显(胃61例,肠59例),肠道B细胞淋巴瘤最常见于结肠、盲肠;病理分类最常见为DLBCL及MALT,其次为MCL和Burkitt,极少见FL;MCL和FL大体表现为息肉状肿物,MALT主要表现为黏膜糜烂及小溃疡,DLBCL主要表现为溃疡,且较MALT所见溃疡体积大,肿瘤的大体表现对分类有提示作用;结合大体所见、HE形态及免疫表型能对绝大部分胃肠道B细胞淋巴瘤做出正确诊断及分类。
Objective: To investigate the clinical characteristics, classification features and pathological diagnosis of gastrointestinal B cell lymphoma in Meizhou area. Methods: The clinical data, histological morphology and immunophenotype of 120 cases of primary gastrointestinal tract B-cell lymphoma were analyzed, including age, sex, location of disease, endoscopic or surgical resection, histology CD20, CD2, CD5, Bcl2, Bcl6, CD10, Cyclin-D1, Mum-1 and Ki67 were detected by immunohistochemistry and immunohistochemistry. Results The age ranged from 2.5 to 95 years (median age 52 years). The ratio of male to female was 1.2:1. The incidence of the disease was located in 61 cases (50.83%) in the stomach, 16 cases (13.33%) in the small intestine and 4 cases (3.33% ), Cecum in 15 cases (12.50%), colon in 18 cases (15.00%) and rectum in 6 cases (5.00%). Endoscopic or surgical resection showed polyps / nodules / cauliflower in 27 cases 59 cases (49.17%) were pathologically classified into DLBCL, 43 cases (35.83%) with MALT, 10 cases (8.33%) with MCL and 7 cases (5.83%) with Burkitt’s lymphoma 1 cases (0.83%). All cases expressed CD20, but did not express CD2, expressed CD5, Bcl2, Bcl6, CD10, Cyclin-D1, Mum-1 and Ki67 to varying degrees. Conclusion: The incidence of gastrointestinal B-cell lymphoma in Meizhou is slightly higher than that in women (the ratio of men to women is 1.2: 1). There is no significant difference in the incidence of gastrointestinal (61 cases of stomach and 59 cases of intestinal) Common in the colon, cecum; the most common pathological classification of DLBCL and MALT, followed by MCL and Burkitt, with rare FL; MCL and FL generally showed polypoid tumor, MALT mainly mucosal erosion and small ulcers, DLBCL main performance For the ulcer, and larger than the size of the ulcer seen in MALT, the general performance of the tumor has prompted the classification; combined with the general view, HE morphology and immunophenotype can make the correct diagnosis of most gastrointestinal B cell lymphoma and classification.