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1. 重庆医科大学基础医学院病理学教研室
2. 重庆市肿瘤研究所病理科
3. 重庆市第二人民医院病理科
4. 武警重庆总医院病理科
纸质出版日期:2009,
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[1]李丹,米粲,姜清明,叶秀峰,李昱,高敏娜,罗强.12例原发性乳腺弥漫性大B细胞淋巴瘤的临床病理分析[J].重庆医科大学学报,2009,34(05):650-653.
LI Dan, et al. Primary breast diffuse large B cell lymphoma:a clinicopathologic study of twelve cases[J]. Journal of Chongqing Medical University, 2009,34(5):650-653.
目的:观察原发性乳腺弥漫性大B细胞淋巴瘤(Diffuse large B cell lymphoma
DLBCL)的临床病理、免疫表型特征及治疗情况
探讨该肿瘤的诊断、治疗及预后。方法:采用SP法对每例行CD20、CD79a、CD3、CD45RO、CD10、Bcl6、MUM1、Ki-67、CK和EMA等免疫组织化学染色。按WHO(2008年)淋巴瘤分类标准
收集12例DLBCL并对每例进行详细的病理分型及随访。结果:女性10例
男性2例
中位年龄49岁
右乳7例
左乳5例。12例均为AnnArborⅠE期
1例IPI2分
2例IPI1分
9例IPI0分。单侧乳腺无痛性肿块是最常见的临床表现。6例(50%)获得随访资料
其中4例存活
存活时间11~31个月;2例死亡
存活时间分别7、19个月。5例(41.7%)有淋巴上皮病变(Lymphoepithelial lesions
LEL)。7例(58.3%)为中心母细胞性变型
5例(41.7%)为免疫母细胞性变型。8例(66.7%)Bcl6阳性表达
12例(100%)MUM1阳性表达
12例(100%)CD10阴性表达
免疫套餐分型12例DLBCL(100%)全部为non GCB型。Ki-67指数中位40%
7例(58.3%)≥40%。结论:原发性乳腺DLBCL罕见
表现为non GCB型
病理活检加免疫表型检测有助确诊
治疗以联合化疗为主加放疗等的综合治疗方案为宜。
Objective:To investigate the clinicopathologic features
immunohistochemical foundings and prognosis ofprimarybreast diffuse large B cell lymphoma(DLBCL).Methods:Twelve cases of primary breast DLBCL
diagnosed according to the 2008 World Health Organization staging standards for haematopoietic and lymphoid tumors
were retrospectively studied.Immunochemical study was perfomed and follow-up information analyzed.The histopathologic and immunophenotypic features of all cases were summarized.Subclassification was carried out when CD10 and/or Bcl 6 positivity and negativity for MUM1 were considered indicative of germinal center B cell like type DLBCL(GCB DLBCL)and the opposite expression as non germinal center B cell like subtype(non GCB DLBCL).Results:Female 10 patients
male 2 patients.Median age of patients was 49 years.7 patients in right breast
5 patients in left.12(100%)patients in stageⅠE.The International Prognostic Index(IPI)of 1 patients was 2
which of 2 patients was 1
and which of 9 patients was 0.Follow-up information was available in 6 patients(50%)
four of which were still alive and two died(survived 7 and 19 months respectively).The patients usually presented with unilateral painless enlargement of breast.Morphologically
the lymphoma cells of 7 DLBCL cases showed a centroblastic variant
5 a immunoblastic variant.5 patients with lymphoepithelial lesions(LEL).Expression of Bcl6 and MUM1 protein was observed in 8 and 12 cases
respectively
and without expression of CD10 in 12 cases.All of 12 patients with DLBCL belong to the non GCB DLBCL.Most cases demonstrated high proliferation index
the median of Ki-67 index was 40%and more than 40%was found in 7 cases(58.3%).Conclusion:Primarybreast diffuse large B cell lymphoma is a rare entity
and shows a non germinal center B cell phenotype
accurate pathologic diagnosis relies on detailed histologic examination and immunochemical study
and treated mainly by chemotherapy combining with other therapies.
乳腺淋巴瘤B细胞淋巴瘤大细胞弥漫型免疫表型分型预后
BreastLymphomaB cellLymphomalarge celldiffuseImmunophenotypingprognosis
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