[1]范 玲,李文生.结外NK/T 细胞淋巴瘤伴B 淋巴细胞增生2 例的临床病理学研究[J].现代检验医学杂志,2024,39(02):108-112.[doi:10.3969/j.issn.1671-7414.2024.02.020]
　FAN Ling,LI Wensheng.Clinicopathological Study of Two Cases of Extranodal NK/T-cell Lymphoma with B-Lymphocytosis[J].Journal of Modern Laboratory Medicine,2024,39(02):108-112.[doi:10.3969/j.issn.1671-7414.2024.02.020]
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结外NK/T 细胞淋巴瘤伴B 淋巴细胞增生2 例的临床病理学研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第39卷
期数:
2024年02期
页码:
108-112
栏目:
论著
出版日期:
2024-03-31

文章信息/Info

Title:
Clinicopathological Study of Two Cases of Extranodal NK/T-cell Lymphoma with B-Lymphocytosis
文章编号:
1671-7414（2024）02-108-05
作者:
范 玲1; 李文生2
（1. 西安医学院，西安 710021；2. 陕西省人民医院病理科，西安 710068）
Author(s):
FAN Ling1;  LI Wensheng2
（1. Xi’an Medical College, Xi’an 710021, China; 2. Department of Pathology, Shaanxi Provincial People’s Hospital, Xi’an 710068, China）
关键词:
结外NK/T 细胞淋巴瘤; B 淋巴细胞增生; 反应性增生
分类号:
R733.4；R446.8
DOI:
10.3969/j.issn.1671-7414.2024.02.020
文献标志码:
A
摘要:
目的 探讨结外NK/T 细胞淋巴瘤（extranodal NK/T cell lymphoma，ENKTL) 伴B 淋巴细胞增生病例的临床病理学特征。方法 收集陕西省人民医院2023 年6 ～ 9 月确诊的2 例ENKTL 伴B 淋巴细胞增生病例，采用HE 染色、免疫组织化学和原位杂交EB病毒编码的小RNA（Epstein-barr virus encoded small RNA，EBER）检测，观察其组织学特征、免疫表型及原位杂交EBER 检测结果，并进行相关文献复习。结果 2 例老年男性患者，病变部位均为右侧鼻腔，组织学特征为肿瘤细胞弥漫分布，细胞大中小不等，以中大细胞为主，胞核不规则，胞质淡染或透明，核椭圆形，染色质呈颗粒状，核仁不明显，核分裂象较多见，凝固性坏死及凋亡明显；背景见小淋巴细胞灶状聚集，淋巴滤泡散在分布。免疫组织化学CD2，CD3，CD56，TIA-1 和颗粒酶B（GrB）阳性表达；CD20，CD79a 和PAX-5 局灶阳性表达；CD21，CD23 及CD35 见残存FDC 网；CD5 阴性表达；Ki-67 增殖指数约30％。原位杂交检测EBER 肿瘤细胞阳性。病理诊断：ENKTL 伴B 淋巴细胞增生。结论 结外NK/T 细胞淋巴瘤伴B 淋巴细胞增生少见，尤其是B 淋巴细胞增生形成淋巴滤泡时，经验不足很容易造成诊断困扰，需结合临床表现、组织学形态、免疫表型综合分析和诊断。
Abstract:
Objective To investigate the clinicopathological characteristics of extranodal NK/T cell lymphoma (ENKTL) with B-lymphocytosis. Methods Two cases of ENKTL with B-lymphocytosis diagnosed in Shaanxi Provincial People’s Hospital from June to September 2023 were collected. HE staining, immunohistochemistry, and in situ hybridisation Epsteinbarr virus encoded small RNA(EBER) testing was used to observe the histological features, immunophenotypes, and results of the in situ hybridisation EBER testing. A review of the relevant literature was conducted. Results In two cases of elderly male patients, whose lesion sites were on both the right side of the nasal cavity, histological characteristics of the tumor cells were diffuse distribution. The cells were of different sizes, mainly medium and large cells, with irregular nuclei, stained or transparent cytoplasm, oval nuclei, granular chromatin and inconspicuous nucleoli. Nuclear schizophrenia was more common and coagulative necrosis and apoptosis were evident. Foci of small lymphocyte aggregates were seen in the background and lymphoid follicles were distributed in a scattered manner. Immunohistochemical CD2, CD3, CD56, TIA-1 and granzyme B (GrB) were positive. CD20, CD79a and PAX-5 were focal positive. CD21, CD23 and CD35 had residual FDC network, and CD5 was negative. Ki-67 proliferation index was approximately 30%. EBER tumor cells detected by in situ hybridisation were positive. Pathological diagnosis showed ENKTL with B-lymphocytosis. Conclusion NKTL with B-lymphocytosis was rare, especially when B-lymphocyte hyperplasia formed lymphoid follicles. Lack of experience can easily cause diagnostic difficulties, and comprehensive analysis and diagnosis should be combined with the clinical manifestations, histological morphology and immunophenotype.

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备注/Memo

备注/Memo:
基金项目：陕西省重点研发项目（2023-YBSF-668)；陕西省人民医院领军人才支持计划项目（2021 LJ-12）。
作者简介：范玲（1990-），女，在读硕士，住院医师，研究方向：肿瘤病理诊断，E-mail：1226706128@qq.com。
通讯作者： 李文生（1968-），男，医学博士，主任医师，研究方向：肿瘤病理诊断及淋巴瘤病理研究，E-mail：liwensheng263@sohu.com。
更新日期/Last Update: 2024-03-15