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目的:探讨1例乳腺原发性前驱T淋巴母细胞淋巴瘤患者的临床病理特征、诊断与鉴别诊断。方法:对1例乳腺原发性前驱T淋巴母细胞淋巴瘤患者的病理组织进行光镜和免疫组化检测,并结合文献复习。结果:组织学镜检见肿瘤细胞呈弥漫浸润性生长,肿瘤细胞中等大小,胞质少,核染色质细颗粒状,核分裂象多见。免疫表型示,瘤细胞呈CD3、CD5、CD43和末端脱氧核苷酸转移酶(TdT)、CD79α阳性,T细胞活化连接蛋白(LAT)、CD10、bcl-2散在阳性;Pax-5、CD20、CD99和MPO均阴性,Ki-67增殖指数为40%。结论:前驱T淋巴母细胞淋巴瘤是一种较为少见的高度恶性肿瘤,原发于成人乳腺者极为罕见,而其诊断及鉴别诊断主要依赖于病理形态学和免疫组化标志。
Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of a patient with primary prolymphocytic lymphoma of the breast. Methods: The histopathology of one patient with primary prolymphocytic T lymphoblastic lymphoma was examined by light microscopy and immunohistochemistry, combined with literature review. Results: Tissue microscopy showed diffuse infiltration of tumor cells growth, tumor cells of medium size, less cytoplasm, fine nuclear chromatin, mitotic common. The immunophenotype showed that tumor cells were positive for CD3, CD5, CD43 and terminal deoxynucleotidyl transferase (TdT), CD79α positive, T cell activated connexin (LAT), CD10 and bcl-2; Pax-5 and CD20 , CD99 and MPO were negative, Ki-67 proliferation index was 40%. CONCLUSION: Precursor T lymphoblastic lymphoma is a rare and highly malignant tumor. It is extremely rare in primary breast cancer patients. The diagnosis and differential diagnosis mainly depend on pathomorphology and immunohistochemical markers.