摘要
目的探讨伴嗜酸性粒细胞(EC)反应的肠病型T细胞淋巴瘤的临床病理特征、发生及变异。方法对1例空肠伴大量EC反应的T细胞淋巴瘤的临床、病理和免疫学表型进行观察、分析及文献复习。结果患者有腹痛、黑便、消瘦及术后11个月复发等临床特点。肿瘤在肠壁弥漫生长,使局部增厚形成肿块。原发瘤细胞稀疏,体积较小,胞质少,核多为圆形,异型性不明显;尤为突出的是大量EC浸润在瘤细胞之间,致使瘤细胞松散分布不易辨认。复发后的瘤细胞数量增多或成片,EC奇迹般地消失。瘤细胞CD3、CD43、CD45RO和CD56(+),CD68散在(+),CD20、CD79α、TiA-1、粒酶B和EBV(-),但程度有变异。结论肠病型T细胞淋巴瘤伴大量EC反应是一种极其少见的现象。是否为肠病型T细胞淋巴瘤的一种亚型,尚无定论。该病例瘤细胞形态小而较圆,散在分布,局部形成肿块伴大量EC浸润,但复发后EC消失,免疫表型变异,其病理机制需进一步研究。
Objective To investigate the clinical and pathological features, histogenesis and variance of enteropathy T cell lymphoma with heavy infiltration of eosinophilia. Methods One case of enteropathy T cell lymphoma with heavy infiltration of eosinophilia was studied with clinical findings, histopathology and immtmophenotype as well as literature review. Results A case of 71-year-old male presented with bellyache, tarry stool, weight loss and recurrence after 11 months. The tumour showed diffuse infitration in the small bowel wall and became a mass. The cells were sparse, small-sized, scanty cytoplasm with roundish and atypical nucleus. There were numerous eosinophilia cells infiltrated in tumour cells and ttunour cells were indecipherable. The tumour cells of recurrence increased and became flaky, but eosinophilia cells dismissed. The cells showed positive for CD3, CD43, CD45RO,and CD56, dispersedly positive for CD68, but negative for CD20, CD79α, KIA-1, granzyme B, and EBV. Conclusions The enteropathy T cell lymphoma with heavy infiltration of eosinophilia is a rare lymphoma of intestinal tract. Whether it is a subtype of enteropathy T-cell lymphoma or not is unsure. The case has no characteristic clinical manifestations. The tumour cells are small and round, diffuse,and become a mass with heavy infiltration of eosinophilia, and the eosinophil cells dismiss in recurrent tumour. The mechanism of the disease needs to be further investigated.
出处
《诊断病理学杂志》
CSCD
2006年第4期294-296,i0014,共4页
Chinese Journal of Diagnostic Pathology
