摘要
目的 探讨肾上腺弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma,DLBCL）的临床病理学特征、免疫表型、鉴别诊断及治疗。方法 回顾性分析6例肾上腺DLBCL的临床病理学特征、影像学资料、免疫表型、治疗及预后,并复习相关文献。结果6例肾上腺DLBCL中男性3例,女性3例;2例为双侧肾上腺占位,3例为右侧,1例为左侧;其中仅1例确诊为原发,1例可疑原发,其他4例为继发;2例伴脾肿大,1例伴外周血皮质醇升高。免疫表型：6例肾上腺DLBCL表达CD20、CD79a或PAX5,T细胞标记CD3和CD43均阴性,Ki-67增殖指数50%-80%;4例表达MUM1,不表达CD10和BCL-6。随访：3例死亡,分别生存9个月、12个月和24个月。2例存活。1例失访。结论 肾上腺淋巴瘤少见,其中以继发性多见,原发性罕见。病理类型以DLBCL最常见。治疗以联合化疗为主,预后差。
Purpose To investigate the clinicopathological characteristics, diagnosis, differential diagnosis, immunohistochemistry and treatment of adrenal diffuse large B-cell lymphoma （DLBCL）. Methods Six cases of adrenal DLBCL pathological features, clinical data, imaging data, treatment and prognosis were observed and related literatures were reviewed. Results The 6 cases consisted of 3 males and 3 females. 3 cases involved the right adrenal gland, 1 case the left, and the other 2 cases bilateral adrenal glands. Only 1 case was confirmed as primary, another case was suspected as primary, and 4 cases were secondary. There were 2 cases presenting with splenomegaly, and 1 case with increased cortisol level. Immunohistochemically, CD20, CD79a and PAX5 were expressed with diffuse and strong staining for adrenal DLBCL of 6 cases. CD3 and CD43 were negative. Ki-67 proliferation index of adrenal DLBCL of 6 cases was expressed for 50% - 80%. MUM1 was diffusely positive and CD10, BCL-6 were negative for four cases. The date of last follow-up was September 22, 2015. 3 patients died with a follow-up survival time of 9, 12, 24 months, respectively. 2 patients were alive, and 1 patient dropped out. Conclusion A majority of adrenal lymphoma is secondary, and primary adrenal lymphoma is rare. The most common type is DLBCL. The principal treatment is adjuvant combination chemotherapy, and prognosis is poor.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2016年第4期400-404,共5页
Chinese Journal of Clinical and Experimental Pathology
关键词
肾上腺肿瘤
弥漫大B细胞淋巴瘤
诊断
预后
免疫组织化学
adrenal neoplasms
diffuse large B-cell lymphoma
diagnosis
prognosis
immunohistochemistry
