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目的探讨EBV阳性的原发性中枢神经系统弥漫性大B细胞性淋巴瘤(DLBCL)的病理诊断和临床病理特点。方法对1例EBV阳性的中枢神经系统DLBCL的临床病理特点、免疫组化标记以及影像学特点进行详细分析,并结合相关文献进行复习。结果患者T1WI示低信号均质团块,T1WI增强示高信号均质团块,T2WI示等信号均质团块。肿瘤周围轻度水肿。肿瘤由大淋巴细胞构成,呈浸润性生长,肿瘤间质少,可见血管套袖结构,瘤细胞呈中心母细胞形态,可见数个小核仁,核分裂象易见。免疫组化肿瘤细胞LCA、CD20、CD79α、bcl-6和EBV(+),Ki-67约60%。结论 EBV阳性的原发性中枢神经系统DLBCL是罕见的恶性肿瘤,其预后较差;诊断需依靠MRI、病理、免疫组化等综合手段;化疗和放疗联合治疗可提高其生存期。
Objective To investigate the pathological diagnosis and clinicopathological features of EBV-positive primary central nervous system diffuse large B-cell lymphoma (DLBCL). Methods One case of EBV-positive central nervous system DLBCL was analyzed clinically and pathologically, immunohistochemically and immunohistochemically, and its imaging features were reviewed in detail. Results T1WI showed low signal homogeneous mass, T1WI enhanced high signal homogeneous mass, T2WI mass signal homogeneous mass. Mild tumor surrounding edema. Tumor consists of large lymphocytes, was invasive growth, tumor stroma less visible vascular sleeve sleeve structure, tumor cells were centroblasts morphology, showing a few small nucleoli, mitotic easy to see. Immunohistochemical tumor cells LCA, CD20, CD79α, bcl-6 and EBV (+), Ki-67 about 60%. Conclusion EBV-positive primary central nervous system DLBCL is a rare malignant tumor with poor prognosis. Diagnosis should be based on comprehensive methods such as MRI, pathology and immunohistochemistry. Chemotherapy and radiotherapy combined therapy can improve its survival.