12例卵巢原发性淋巴瘤临床病理学研究-现代医学

12例卵巢原发性淋巴瘤临床病理学研究

单位：1. 江苏省人民医院浦口分院/南京市浦口人民医院妇产科, 江苏南京 211800;
2. 江苏省肿瘤医院病理科, 江苏南京 210009

分类号：R737.31

出版年·卷·期（页码）：2023·51·第十二期（1674-1679）

摘要：

目的：研究12例卵巢原发性淋巴瘤的临床病理学特征。方法：分析12例卵巢原发性淋巴瘤的组织病理学、免疫表型、原位杂交、荧光原位杂交特点及诊断与鉴别诊断要点。结果：病例1~7肿瘤由大淋巴细胞构成，瘤细胞表达广谱B细胞标记CD20和PAX5，Ki-67增殖指数大于40%，诊断为弥漫大B细胞淋巴瘤。病例8~11肿瘤细胞由单形性中等大小弥漫生长的富于黏附性的淋巴细胞组成，“星空”现象多见。瘤细胞CD20、BCL6和CD10阳性，肿瘤细胞c-myc高表达，Ki-67增殖指数接近100%，荧光原位杂交提示MYC基因重排，诊断为Burkitt淋巴瘤。病例12由幼稚的小淋巴细胞组成，细胞质稀少蓝灰色，肿瘤细胞CD20、CD10、CD34、CD117和TDT阳性，诊断为B淋巴母细胞淋巴瘤。结论：卵巢原发性淋巴瘤根据临床病程病理分为弥漫大B细胞淋巴瘤、Burkitt淋巴瘤和B淋巴母细胞淋巴瘤，其诊断、鉴别诊断与病理分型依赖于临床、病理组织形态学、免疫组织化学及分子遗传学。

Objective: To explore the clinicopathologic characteristics of 12 cases of primary ovarian lymphoma. Methods: The histomorphology, immunophenotype, in situ hybridization, fluorescence in situ hybridization(FISH), diagnostic and differential diagnostic features of 12 patients with primary ovarian lymphoma were analyzed. Results: A diffuse proliferation of large lymphoid cells was seen in cases 1-7. The neoplastic cells typically expressed pan-B-cell markers such as CD20 and PAX5,and the Ki-67 proliferation index was greater than 40%,which led to diagnosis of diffuse large B-cell lymphoma.The tumor cells in cases 8-11 were medium sized and showed a diffuse monotonous pattern of growth. The tumor cells appeared to be cohesive. A so-called starry sky pattern was usually present.The tumor cells typically expressed CD20, BCL6 and CD10, and the tumor cell highly expressed c-myc, and the Ki-67 proliferation index was nearly 100%, and fluorescence in situ hybridization suggested that MYC gene was rearrangeed,which led to diagnosis of Burkitt lymphoma.Case 12 was composed of small sized blast cells with scant bluish-grey cytoplasm. The tumor cells were positive for CD20, CD10, CD34, CD117 and TDT,and was diagnosed as B-lymphoblastic lymphoma. Conclusion: Primary ovarian lymphoma is very rare. The diagnosis, differential diagnosis and histological type of primary ovarian lymphoma needs a constellation of clinical findings, pathological histomorphology, immunohistochemistry and molecular genetics.

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