[Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 27 cases]
- PMID: 28910870
- DOI: 10.3760/cma.j.issn.0529-5807.2017.09.004
[Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 27 cases]
Abstract
Objective: To study the clinicopathologic characteristics and diagnostic criteria of primary mediastinal B-cell lymphoma (PMBL), and to distinguish PMBL from classic Hodgkin lymphoma(CHL) and systemic diffuse large B-cell lymphoma(DLBCL). Methods: The clinical features, histologic findings, results of immunohistochemical study and prgnosis in 27 PMBL cases were analyzed, with review of literature. Results: The age of patients ranged from 19 to 82 years (median age 34 years). All cases were located in the mediastinum and frequently accompanied by superior vein cava syndrome. Histologically, the tumor cells were pleomorphic and diffusely distributed. Clear cytoplasm and spindle tumor cells were seen in some cases. Varying amount of sclerosing stroma with collagen deposition was seen.Immunohistochemical study showed that the tumor cells were positive for CD20(100%, 27/27), CD30 (64.0%, 16/25), CD23 (77.3%, 17/22) and p63 (16/19). Clonal B cell gene rearrangement was seen. Conclusions: PMBL is a subtype of diffuse large B-cell lymphoma with various histomorphology. Immunohistochemistry can help to confirm the diagnosis, and the prognosis is better than diffuse large B cell lymphoma, not otherwise specified.
目的： 探讨原发纵隔大B细胞淋巴瘤(PMBL)的临床表现及病理特征，进一步区分与经典型霍奇金淋巴瘤和系统性弥漫大B细胞淋巴瘤非特殊亚型的鉴别诊断方法。 方法： 收集27例PMBL作为研究对象，分析其临床特征及病理形态学改变、患者预后，采用免疫组织化学染色，检测不同抗体的阳性表达情况。 结果： 27例PMBL患者好发于年轻人(中位年龄34岁)，均发生于纵隔，常因肿瘤巨大而压迫引起相应症状。肿瘤细胞形态多样，中等大细胞弥漫分布，细胞呈单核类圆形或多核瘤巨细胞，透明细胞或梭形细胞样多见，间质均有不同程度的硬化。免疫组织化学染色显示瘤细胞表达CD20(27/27，100%)、CD30(16/25，64.0%)、CD23(17/22，77.3%)、p63(16/19)。基因重排显示B细胞单克隆增生。 结论： PMBL属于弥漫大B细胞淋巴瘤的一种亚型，具有独特的临床病理学特点，组织形态复杂多样，免疫组织化学可助明确诊断，患者预后较好。.
Keywords: Diagnosis, differential; Lymphoma, B-cell; Mediastinal neoplasms.
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