摘要
目的探讨乳腺淋巴瘤(breast lymphoma,BL)的临床病理学特征、诊断及鉴别诊断。方法收集72例BL的临床病理资料,采用免疫组化EnVision两步法染色,应用FISH法检测C-myc、BCL-2、BCL-6基因扩增及断裂重排情况;应用BIOMED-2 PCR检测T/B细胞基因重排;运用原位杂交法检测EBER,分析其与临床病理特征的关系。结果72例BL中女性69例,男性3例;发病年龄24~83岁,中位年龄55岁。BL影像学特征具有非特异性,与乳腺癌的临床表现相似;72例BL中弥漫大B细胞淋巴瘤(diffused large B cell lymphoma,DLBCL)52例,结外黏膜相关淋巴组织边缘区淋巴瘤(extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue,MALT)7例,T淋巴母细胞性淋巴瘤(T lymphoblastic lymphoma,T-LBL)6例,其余少见类型为7例。52例DLBCL经原位杂交检测EBER均阴性,FISH检测2例有BCL-6基因断裂。16例患者具有完整临床病理资料,原发性乳腺淋巴瘤(primary breast lymphoma,PBL)12例,继发性乳腺淋巴瘤(secondary breast lymphoma,SBL)4例,两组患者预后均较差,差异无统计学意义(P>0.05)。结论BL的病理类型以DLBCL为主,男性患者罕见。BL通过影像学鉴别难度较大,主要通过穿刺活检病理诊断;PBL和SBL的临床病理特征及预后,差异无统计学意义。
Purpose To investigate the clinicopathologic features and differential diagnosis of breast lymphoma(BL).Methods The clinicopathologic data of 72 cases of breast lymphoma were collected.EnVision two-step immunohistochemical staining and FISH was used to detect the amplification and break rearrangement of C-myc,BCL-2 and BCL-6 genes.T/B cell gene rearrangement was detected by capillary electrophoresis;EBV was detected with in situ hybridization.Its relationship with clinicopathological features were analyzed.Results Of the 72 patients with breast lymphoma,69 were female and 3 were male.The age of onset ranged from 24 to 83 years with a median age of 55 years.The imaging features of breast lymphoma were nonspecific and similaRto those of breast cancer.The most common pathological type was diffused large B cell lymphoma(DLBCL)in 52 cases,followed by extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT)(7 cases),T lymphoblastic lymphoma(T-LBL)(6 cases),the remaining 7 cases were rare types.Pathological diagnosis of all types of BL were combined with relevant immunohistochemical markers and/oRT/B cell gene rearrangement results.Among them,EBERin situ hybridization test of DLBCL was negative in 52 cases,and BCL-6 gene disruption was detected in 2 cases by FISH.16 patients had complete clinical and pathological data,12 cases had primary breast lymphoma(PBL)and 4 cases had secondary breast lymphoma(SBL).Patients with PBL and SBL had a pooRprognosis,but there was no statistically difference(P>0.05).Conclusion The pathological type of breast lymphoma is mainly DLBCL,and male cases are very rare.Imaging identification of breast lymphoma is difficult;its diagnosis is mainly through biopsy and puncture pathology.There is no significant difference in clinicopathological features and prognosis between PBL and SBL.
作者
周晓蝶
戚荣鑫
余波
王璇
李锐
叶胜兵
石群立
饶秋
周晓军
鲍炜
ZHOU Xiaodie;QI Rongxin;YU Bo;WANG Xuan;LI Rui;YE Shengbin;SHI Qunli;RAO Qiu;ZHOU Xiaojun;BAO Wei(Department of Pathology,General Hospital of Eastern Theater Command/Jinling Hospital,Nanjing University School of Medicine,Nanjing 210002,China;Department of NucleaRMedicine,General Hospital of Eastern Theater Command/Jinling Hospital,Nanjing University School of Medicine,Nanjing 210002,China)
出处
《临床与实验病理学杂志》
CAS
北大核心
2023年第8期925-930,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
江苏省第十六批六大人才高峰项目(WSN-043)、江苏省第六期333高层次人才项目[(2022)3-28-020]、江苏省青年医学重点人才项目(QNRC2016918)。
关键词
乳腺肿瘤
淋巴瘤
临床病理特征
鉴别诊断
breast neoplasms
lymphoma
clinicopathologic features
differential diagnosis
