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目的观察肝假性淋巴瘤的临床病理学特点、免疫表型、鉴别诊断与预后特征。方法对4例肝假性淋巴瘤的临床病理特征、免疫表型、免疫球蛋白重链克隆重排进行观察,并结合文献探讨该肿瘤的病理诊断与鉴别诊断。结果 4例患者中男性2例,女性2例,年龄38～66岁,中位年龄52岁。2例有慢性肝炎病史(慢性活动性B型和C型肝炎各1例)。肿瘤直径1～2.5 cm,平均1.75 cm。组织学上,肿瘤由成熟的小淋巴细胞和浆细胞组成,可见生发中心的淋巴滤泡、上皮样组织细胞和无特征性的淋巴上皮病变,淋巴细胞无明显异型性,可沿肿瘤周、肝门管区浸润。免疫组化和基因重排分析显示,淋巴细胞为多克隆性。术后随访所有病例未见恶性转化。结论肝假性淋巴瘤为罕见的、良性淋巴组织增生性病变,形态学特征、免疫组化染色和基因重排在肝假性淋巴瘤诊断中具有重要价值。
Objective To observe the clinicopathological features, immunophenotype, differential diagnosis and prognosis of hepatic pseudolymphoma. Methods The clinicopathological features, immunophenotypes and immunoglobulin heavy chain clone rearrangements of 4 cases of hepatic pseudolymphoma were observed. The pathological diagnosis and differential diagnosis of this tumor were also discussed. Results There were 2 males and 2 females in 4 patients. The age ranged from 38 to 66 years. The median age was 52 years. 2 patients had a history of chronic hepatitis (chronic active type B and hepatitis C in 1 case). Tumor diameter of 1 ~ 2.5 cm, an average of 1.75 cm. Histologically, the tumor consists of mature small lymphocytes and plasma cells, showing lymphoid follicles, epithelioid cells and non-characteristic lymphoid epithelial lesions in the germinal center. There is no obvious atypia of lymphocytes, Portal area infiltration. Immunohistochemistry and gene rearrangement analysis showed that lymphocytes were polyclonal. All patients were followed up without malignant transformation. Conclusions Hepatic pseudolymphoma is a rare and benign lymphoproliferative lesion. Morphological features, immunohistochemical staining and gene rearrangement are of great value in the diagnosis of hepatic pseudolymphoma.