本文關(guān)鍵詞：肺淋巴瘤樣肉芽腫5例臨床病理分析　出處：《臨床與實(shí)驗(yàn)病理學(xué)雜志》2016年08期 　論文類型：期刊論文

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【摘要】：目的探討肺淋巴瘤樣肉芽腫(pulmonary lymphomatiod granulomatosis,PLG)臨床病理學(xué)特征。方法回顧性分析5例PLG的臨床資料、組織學(xué)形態(tài)、免疫表型及分子生物學(xué)特點(diǎn),并復(fù)習(xí)相關(guān)文獻(xiàn)。結(jié)果 5例患者均為男性,年齡7~74歲,平均36.6歲;其中2例有發(fā)熱病史;鏡下均見中至大量異型淋巴樣細(xì)胞彌漫浸潤(rùn),其中3例可見大片凝固性壞死及顯著的血管壁異型淋巴樣細(xì)胞浸潤(rùn)伴纖維素樣壞死;免疫表型:異型淋巴樣細(xì)胞CD20、PAX-5、LMP1均陽(yáng)性,EBER原位雜交檢測(cè)顯示數(shù)量不等的陽(yáng)性,背景小淋巴細(xì)胞CD2、CD3、CD5陽(yáng)性。依據(jù)反應(yīng)性淋巴細(xì)胞背景中EB病毒陽(yáng)性B細(xì)胞的比例,診斷PLG 3級(jí)2例,PLG 2級(jí)2例,PLG1~2級(jí)1例;術(shù)后隨訪時(shí)間6~16個(gè)月,平均9個(gè)月,均無(wú)復(fù)發(fā)和轉(zhuǎn)移。結(jié)論 PLG是一種EB病毒相關(guān)的B細(xì)胞淋巴組織增殖性疾病,成年人居多,癥狀多樣,肺部呈多發(fā)或單發(fā)病灶。診斷主要依靠病變中大量炎性細(xì)胞伴多少不等的中等大至大的異型B淋巴細(xì)胞且EB病毒陽(yáng)性,以及嗜血管現(xiàn)象和灶片狀壞死。同時(shí)應(yīng)注意排除肺部炎性疾病和霍奇金淋巴瘤。
[Abstract]:Objective to investigate pulmonary lymphomatiod granulomatosis of pulmonary lymphoma granuloma. Methods the clinical data, histological morphology, immunophenotypic and molecular biological characteristics of 5 cases of PLG were analyzed retrospectively. The average age was 36.6 years. Two of them had a history of fever. Under the microscope, a large number of atypical lymphoid cells were infiltrated, 3 of which showed large coagulative necrosis and significant infiltration of vascular wall abnormal lymphoid cells with cellulose like necrosis. Immunophenotypes: CD20, PAX-5 and LMP1 were all positive. EBER in situ hybridization showed that the number of CD2 + CD2 + CD3 was different, and CD2 + CD3 was detected by EBER in situ hybridization. According to the proportion of EB virus positive B cells in reactive lymphocyte background, 2 cases of PLG grade 3 and 2 cases of PLG grade 2 were diagnosed as grade 2 of PLG and 1 case of grade 2 of PLG. The follow-up time was 6 ~ 16 months (mean 9 months), and no recurrence or metastasis was found. Conclusion PLG is a proliferative disease of B cell lymphoid tissue associated with Epstein-Barr virus (EBV). The diagnosis mainly depends on the large number of inflammatory cells in the lesion accompanied by varying amounts of medium to large abnormal B lymphocytes and EBV positive. Haemophilus and focal necrosis. At the same time should be careful to exclude pulmonary inflammatory diseases and Hodgkin's lymphoma.
【作者單位】： 湖北省宜昌市中心人民醫(yī)院病理科;北京友誼醫(yī)院病理科;
【分類號(hào)】：R563
【正文快照】： 淋巴瘤樣肉芽腫(lymphomatiod granulomatosis,LYG)是一種結(jié)外血管中心性和血管破壞性淋巴組織增殖性病變,其由EB病毒感染的不典型的多形性B細(xì)胞浸潤(rùn)和大量混合性反應(yīng)性T細(xì)胞組成,缺乏真正的肉芽腫特點(diǎn),可進(jìn)展為EB病毒陽(yáng)性的彌漫大B細(xì)胞淋巴瘤[1]。臨床罕見,其常發(fā)生于成人,但

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1 錢民,王偉中,黃文杰;肺淋巴瘤樣肉芽腫二例[J];臨床放射學(xué)雜志;1999年01期

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