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目的提高对儿童原发性中枢神经系统间变性大细胞性淋巴瘤(ALCL)侵及脑膜伴脑脊液播散的认识,减少对ALCL的误诊。方法对1例ALCL临床资料进行分析,光镜观察脑脊液细胞学特征,原发部位组织学形态结构和免疫表型,并复习文献。结果中枢神经系统ALCL侵及脑膜,肿瘤细胞在脑脊液中出现,形态多样,核膜不清,核分裂可见。形态特征与原发部位肿瘤细胞相似,免疫组化:ALK、TIA和GRB(+),GFAP和Neu-N(-),Ki-67增殖指数为60%。p53 3%(+)。结论中枢神经系统是ALCL的少发部位,脑脊液中肿瘤细胞的检出有助于提高ALCL的诊断。
Objective To improve the understanding of children with primary central nervous system interstitial large cell lymphoma (ALCL) invasion and cerebrospinal fluid dissemination, and to reduce the misdiagnosis of ALCL. Methods The clinical data of 1 case of ALCL were analyzed. The cytological characteristics of cerebrospinal fluid, histological structure and immunophenotype of primary site were observed by light microscope and the literature was reviewed. Results Central nervous system ALCL invasion of the meninges, tumor cells in the cerebrospinal fluid in the emergence of various forms, unclear nuclear membrane, nuclear fission visible. Morphological characteristics were similar to that of primary tumor cells. Immunohistochemistry showed that ALK, TIA and GRB (+), GFAP and Neu-N (-), Ki-67 proliferation index was 60%. p53 3% (+). Conclusion The central nervous system is a rare site of ALCL. The detection of tumor cells in cerebrospinal fluid can help to improve the diagnosis of ALCL.