论文部分内容阅读
目的探讨老年人EBV阳性的弥漫性大B细胞性淋巴瘤(DLBCL)的组织形态特征、免疫组化、诊断与鉴别诊断、治疗与预后。方法对1例淋巴结发生的老年人EBV阳性的DLBCL行HE和免疫组化染色,同时行TCR基因和免疫球蛋白基因的克隆分析。结果患者男性,60岁。颈部、腋窝及锁骨上窝淋巴结肿大3个月。组织学表现为富于组织细胞与T细胞的大B细胞性淋巴瘤(THRBCL),肿瘤显示NF-κb途径激活,同时伴有显著类上皮反应及T细胞克隆性扩增。结论老年人EBV阳性的DLBCL是新近发现的一类EBV阳性的单克隆性B淋巴细胞增生性疾病,其临床和病理特征独特,需与伴有肉芽肿反应的EBV阳性的淋巴组织增生性疾病或淋巴瘤进行鉴别,本例同时伴有显著类上皮肉芽肿反应和克隆性T细胞扩增非常罕见。
Objective To investigate the morphological features, immunohistochemistry, diagnosis and differential diagnosis, treatment and prognosis of EBV-positive diffuse large B-cell lymphoma (DLBCL) in the elderly. Methods EBV-positive DLBCL was performed in 1 case of lymph node metastases and HE staining and immunohistochemical staining. TCR gene and immunoglobulin genes were cloned and analyzed. Results The patient was male, 60 years old. Neck, axillary, and supraclavicular fossa were swollen with lymph nodes for 3 months. Histologically, it is a large B-cell lymphoma (THRBCL) rich in histiocytes and T cells. Tumors show activation of the NF-kappaB pathway accompanied by significant epithelial reactions and clonal expansion of T cells. Conclusion The EBV positive DLBCL in the elderly is a newly discovered EBV positive monoclonal B-lymphocyte proliferative disease. Its clinical and pathological features are unique. It needs to be associated with EBV-positive lymphoproliferative disease with granulomatous reaction or Lymphomas are identified and this case is accompanied by a significant epithelial granuloma reaction and clonal T cell expansion is very rare.