摘要
目的:探讨皮下脂膜炎样T细胞淋巴瘤(subcutaneous panniculitis-like T-cell lymphoma,SPTCL)的临床病理特征、诊断与鉴别诊断。方法:对1例SPTCL行HE染色和免疫组织化学标记,抗体为CD3、CD45RO、CD20、CD79a、CD4、CD8、CD30、CD56、CD68、TIA-1等。结果:患者表现为发热、左中腹至左腹股沟区红肿,辅助检查提示贫血、白细胞和血小板减少、肝功能异常、肝脾肿大。镜检:肿瘤位于皮下组织,呈脂膜炎样生长,瘤细胞围绕单个脂肪细胞呈花环状排列,瘤细胞小至中等大,偶见散在的大细胞,核碎裂和核分裂象易见,并可见肿瘤性坏死、出血和脂肪坏死以及组织细胞反应。免疫表型:瘤细胞表达CD3、CD8、CD45RO、CD30、TIA-1,而CD4、CD20、CD79a、CD56、CD68阴性。患者从发病到死亡仅2月余。结论:SPTCL是一种罕见的原发于皮下脂肪组织的细胞毒T细胞淋巴瘤,一般预后较好,伴有嗜血细胞综合征和其他症状者预后可能较差。
Objective：To study the clinicopathologic features,diagnosis and differential diagnosis of subcutaneous panniculitis-like T- cell lymphoma（ SPTCL）. Methods ： One case of SPTCL was examined by HE stainning and immunohistochemistry study. The antibodies which be used were CD3, CD45 RO, CD20, CD79a, CD4, CD8, CD30, CD56, CD68 and TIA-1. Results： The case presented as fever, redness,swelling and skin ulcers in left midabdomen and the left inguinal region. Laboratory abnormalities mainly included anemia, leucopenia, thrombocytopenia, elevated liver function tests and hepatosplenomegaly. The histopathology showed a predominant subcutaneous lobular infihrate with pleomorphic T cells of variable size with irregular and often hyperchromatic nuclei, predominantly with small to medium-sized cells with only scattered large lymphoid cells and rinnning of individual adipocytes by atypical lymphocytes. Mitotic figure and karyorrhexis were present. Fat necrosis, hemon＇hage,tumor-like necrosis and other cellular responses were also present in the tumor. Immunohistochemistry results showed the tumor cells were positive for CD3, CD45 RO, CD8, CD30 and TIA-1, and negative for CD4,CD20,CD79a,CD56 and CD68. The patient died in two months after the onset of the disease. Conclusions： SPTCL is a rare cytotoxic T-c, ell lymphoma involving primarily in subcutaneous fatty tissues,it has a good prognosis commonly. But if a haemophagocytic syndrome and other syndrome is present,the prognosis maybe be poor.
出处
《蚌埠医学院学报》
CAS
2010年第2期136-139,共4页
Journal of Bengbu Medical College
关键词
淋巴瘤
皮下脂膜炎样T细胞淋巴瘤
诊断
鉴别
病理学
临床
lymphoma
subcutaneous panniculitis-like T-cell lymphoma
diagnosis, differential
pathology, clinical
