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目的探讨眼附属器B淋巴母细胞性白血病/淋巴瘤(B lymphoblastic leukaemia/lymphoma,B-ALL/B-LBL)的临床病理学特征、诊断及鉴别诊断。方法对2例眼附属器B-ALL/B-LBL的临床表现、组织学形态及免疫表型进行分析,并复习相关文献。结果例1,男童,10岁,因右眼红肿2个月入院;查体:右眼结膜充血(+),颞侧结膜可见条状红肿状物。例2,男童,13岁,发现右眼肿物半个月入院;罹患白血病3年,曾在儿童医院行化疗。镜检:2例均表现为肿瘤细胞大小相对一致,胞质少,核呈圆形、卵圆形,带凹陷或扭曲,染色质细而分散,核分裂象从不明显到易见;肿瘤细胞呈弥漫浸润性生长,间质成分少。免疫表型:2例肿瘤细胞均弥漫强阳性表达PAX5、TDT、CD34及CD10,不表达CD20、CD3、CD5、CD117和CD30。结论眼附属器B-ALL/B-LBL罕见,熟悉其临床病理学特征及免疫表型,有助于正确诊断。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of ocular adnexal B lymphoblastic leukemia / lymphoma (B-ALL / B-LBL). Methods The clinical manifestations, histological features and immunophenotypes of 2 cases of adnexal B-ALL / B-LBL were analyzed and related literatures were reviewed. Results Example 1, a boy, 10 years old, was admitted to the hospital with an inflamed right eye for 2 months. Physical examination: Conjunctival hyperemia (+) in the right eye and stripy red tangs in the temporal conjunctiva. Example 2, a 13-year-old boy who was admitted to hospital with a right eye tumor for half a month; had leukemia for 3 years and had undergone chemotherapy in a children’s hospital. Microscopic examination: 2 cases showed relatively uniform size of tumor cells, less cytoplasm, nucleus was round, oval, with depression or distortion, fine and scattered chromatin, mitotic phenomenon from obvious to easy to see; tumor cells were Diffuse infiltrative growth, interstitial components less. Immunophenotype: PAX5, TDT, CD34 and CD10 were diffusely and strongly expressed in 2 tumor cells without expression of CD20, CD3, CD5, CD117 and CD30. Conclusion The eye appendage B-ALL / B-LBL is rare, familiar with its clinicopathological characteristics and immunophenotype, which is helpful for the correct diagnosis.