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目的探讨原发性睾丸淋巴瘤(PTL)的临床病理特征,以提高对该疾病的诊治水平。方法收集PTL存档资料33例,进行石蜡切片,常规HE染色,Envision二步法免疫组织化学标记,根据2008年版WHO淋巴与造血组织肿瘤病理学分类标准进行临床病理学分析。结果 PTL占同期睾丸恶性肿瘤的8.3%(33/397)。临床Ⅰ～Ⅱ期28例(85%),Ⅲ～Ⅳ期5例(14%)。组织学分型:33例PTL中弥漫性大B细胞淋巴瘤25例(76%),黏膜相关(MALT)淋巴瘤3例(9%),B淋巴母细胞淋巴瘤1例(3%),外周T细胞淋巴瘤2例(6%),鼻型NK/T细胞淋巴瘤2例(6%)。所有患者均行患侧睾丸根治性切除术。术后随访6～120个月,生存时间6～80个月,平均生存28个月。结论 PTL类型多样,以弥漫性大B细胞淋巴瘤最多见。PTL确诊依赖于病理学检查。正确的病理诊断,明确免疫表型,进而制定相应的放化疗方案,可有效改善预后。
Objective To investigate the clinicopathological features of primary testicular lymphoma (PTL) in order to improve the diagnosis and treatment of this disease. Methods Thirty-three cases of PTL were collected and paraffin sections, routine HE staining and Envision two-step immunohistochemical staining were performed. The clinicopathological analysis was performed according to the 2008 WHO classification of lymphopoiesis and hematopoietic tumor pathology. Results PTL accounted for 8.3% (33/397) of the testicular cancer in the same period. The clinical stage Ⅰ ~ Ⅱ 28 cases (85%), Ⅲ ~ Ⅳ 5 cases (14%). Tissue typing: 25 cases (76%) of diffuse large B cell lymphoma in PTL, 3 cases (9%) of MALT lymphoma, 1 case of B lymphoblastic lymphoma (3%), T cell lymphoma in 2 cases (6%), nasal NK / T cell lymphoma in 2 cases (6%). All patients underwent ipsilateral testicular radical resection. The patients were followed up for 6 to 120 months and the survival time was 6 to 80 months with an average survival of 28 months. Conclusions Various types of PTLs are most common in diffuse large B-cell lymphoma. PTL diagnosis depends on the pathological examination. The correct pathological diagnosis, a clear immune phenotype, and then develop the appropriate radiotherapy and chemotherapy programs, which can effectively improve the prognosis.