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目的探讨Burkitt淋巴瘤(BL)的临床病理特征、诊断和鉴别诊断。方法收集11例BL和10例弥漫大B细胞淋巴瘤(DLBCL),采用免疫组化EnVision二步法检测肿瘤细胞免疫表型,标记抗体为CD20、PAX-5、CD3、CD7、CD10、bcl-2、bcl-6、MUM-1、Ki-67;采用EBER原位杂交方法检测肿瘤细胞的EBV感染情况。结果根据细胞形态BL分为3种类型:经典型8例,浆样分化型1例,非典型性BL/BL样型2例。BL和DLBCL的所有病例CD20和PAX-5(+)。BL中bcl-2和MUM-1的表达率明显低于DLBCL(P<0.01),而同时表达CD10(+)/bcl-2(-)/bcl-6(+)和Ki-67≥95%的病例明显多于DLBCL(P<0.01)。结论BL是一种高度恶性的B细胞淋巴瘤,免疫组化在BL的诊断及鉴别诊断中有重要作用。BL的倍增时间短,宜采取短疗程、高强度化疗方案。
Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis of Burkitt’s lymphoma (BL). Methods 11 cases of BL and 10 cases of diffuse large B cell lymphoma (DLBCL) were collected. Immunocytochemistry EnVision two-step method was used to detect the immunophenotype of tumor cells. The labeled antibodies were CD20, PAX-5, CD3, CD7, CD10, 2, bcl-6, MUM-1 and Ki-67. EBV infection in tumor cells was detected by EBER in situ hybridization. The results were divided into three types according to cell morphology BL: 8 cases of classic, 1 case of plasma-like differentiation and 2 cases of atypical BL / BL. All cases of BL and DLBCL were CD20 and PAX-5 (+). The expression of bcl-2 and MUM-1 in BL was significantly lower than that in DLBCL (P <0.01), while the expression of CD10 (+) / bcl- More cases than DLBCL (P <0.01). Conclusion BL is a highly malignant B cell lymphoma. Immunohistochemistry plays an important role in the diagnosis and differential diagnosis of BL. BL doubling time is short, should take a short course, high-intensity chemotherapy.