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睪丸原發(fā)性淋巴瘤17例臨床病理分析

發(fā)布時間:2018-11-08 07:13
【摘要】:目的探討睪丸原發(fā)性淋巴瘤(primary testicular lymphoma,PTL)的臨床病理學特征。方法回顧性分析17例PTL的臨床病理學特征。結(jié)果患者年齡37~81歲,中位年齡69歲;以睪丸無痛性腫大為主要臨床表現(xiàn);病變位于左側(cè)6例,右側(cè)10例,雙側(cè)1例;腫塊最大徑2~6 cm。組織學分型:17例PTL中16例(94%)為彌漫大B細胞淋巴瘤(diffuse large B cell lymphoma,DLBCL),1例(6%)為結(jié)外NK/T細胞淋巴瘤(鼻型)。免疫表型提示16例DLBCL中14例為非生發(fā)中心B細胞樣(non-germinal center B-cell-like,non-GCB)型,2例為生發(fā)中心B細胞樣(germinal center B-cell-like,GCB)型;c-myc與BCL-2或BCL-6抗體共同陽性表達者(c-myc陽性率30%以上且BCL-2陽性率70%以上者)10例。對10例共表達病例行FISH檢測,發(fā)現(xiàn)僅1例有MYC基因重排,未發(fā)現(xiàn)雙重打擊淋巴瘤(double-hit lymphoma,DHL)。EB病毒原位雜交檢測除1例鼻型NK/T細胞淋巴瘤為陽性外均為陰性。Ann Arbor臨床分期:Ⅰ+Ⅱ期15例(88%),Ⅲ+Ⅳ期2例(12%)。17例患者均行患側(cè)睪丸根治性切除術(shù),8例DLBCL患者行CHOP或R-CHOP方案化療。結(jié)論 PTL發(fā)病率低,主要發(fā)生于老年人,最常見的組織學類型為DLBCL,以non-GCB型伴c-myc與BCL-2/BCL-6共表達為主,患者預(yù)后差。PTL中很少發(fā)現(xiàn)伴隨MYC和BCL-2同時基因重排的DHL。PTL術(shù)前診斷困難,確診需依靠病理組織學、免疫表型及分子病理學檢查等。
[Abstract]:Objective to investigate the clinicopathological features of primary testicular lymphoma (primary testicular lymphoma,PTL). Methods the clinicopathological features of 17 cases of PTL were retrospectively analyzed. Results the age of the patients was 3781 years with median age of 69 years. The main clinical manifestation was painless testicular enlargement. The lesions were located in 6 cases on the left side, 10 cases on the right side, and 1 case on both sides. The maximum diameter of the mass was 2 ~ 6 cm.. Histological credit type: 16 cases (94%) of PTL were diffuse large B cell lymphoma (diffuse large B cell lymphoma,DLBCL) and 1 case (6%) was extranodular NK/T cell lymphoma (nasal type). The immunophenotype showed that 14 cases of DLBCL were non-germinal center B-cell-like non-GCB type, 2 cases were germinal center B-cell-like (germinal center type. The positive rate of c-myc and BCL-2 or BCL-6 antibody was more than 30% and the positive rate of BCL-2 was more than 70%. FISH detection was performed in 10 coexpression cases. Only 1 case was found to have MYC gene rearrangement, and no double strike lymphoma (double-hit lymphoma,) was found. In situ hybridization of DHL). EB virus was negative for. Ann Arbor clinical staging except for 1 case of nasal NK/T cell lymphoma: 15 cases (88%) were stage 鈪,

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