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96例淋巴母细胞淋巴瘤的临床病理研究

[A clinicopathological study of 96 cases of lymphoblastic lymphoma].

作者信息

Pan Yun, Liu Wei-Ping, Li Jin-Fan, Zhang Wen-Yan, Li Feng-Yuan, Lu Xiao-Xi, Li Dan, Li Gan-di

机构信息

West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2005 Apr;26(4):218-22.

Abstract

OBJECTIVE

To investigate the clinicopathological and immunohistochemical features of lymphoblastic lymphoma (LBL).

METHODS

A retrospective clinicopathological study of 96 cases LBL was carried out. Immunohistochemical staining was used for the characterization and immunophenotyping.

RESULTS

The patients age ranged from 4 to 72 years, with a median of 16 years, 69 patients were male and 27 female. Seventy-three cases had superficial or multi-lymphoadenopathy and 31 of them had mediastinal masses. Bone marrow was involved in 15 cases. Seventy-three cases were in clinical stages III and IV. The median survival of the followed-up patients was 5.5 (2 approximately 120) months. TdT and CD99 positive reactions were 75.0% and 92.7%, respectively. Of the 96 cases, 78 displayed T-cell marker positivity and 18 B-cell markers. 82.1% of the patients younger than 30 years of age had significantly higher incidences of T-LBL (64 patients), and 93.6% of the patients with mediastinal masses expressed T-cell markers. The poor prognostic factors were T-cell tumors, clinical stages III and IV, Ki-67 PI < 80% and no chemotherapy (P < 0.01).

CONCLUSION

In children and young males, mediastinal masses with superficial or multi-lymphoadenopathy favors the diagnosis of LBL, but negative TdT reaction can not exclude this diagnosis. T-LBL is more common than B-LBL. Clinical stages, immunophenotypes and the level of Ki-67 expression were closely related with prognosis of LBL.

摘要

目的

探讨淋巴母细胞淋巴瘤(LBL)的临床病理及免疫组化特征。

方法

对96例LBL进行回顾性临床病理研究。采用免疫组化染色进行特征描述和免疫分型。

结果

患者年龄4至72岁,中位年龄16岁,男性69例,女性27例。73例有浅表或多发淋巴结肿大,其中31例有纵隔肿块。15例累及骨髓。73例处于临床Ⅲ期和Ⅳ期。随访患者的中位生存期为5.5(2至120)个月。TdT和CD99阳性反应分别为75.0%和92.7%。96例中,78例显示T细胞标志物阳性,18例显示B细胞标志物阳性。年龄小于30岁的患者中82.1%的T-LBL发病率显著更高(64例),93.6%的纵隔肿块患者表达T细胞标志物。预后不良因素为T细胞肿瘤、临床Ⅲ期和Ⅳ期、Ki-67增殖指数<80%以及未进行化疗(P<0.01)。

结论

在儿童及青年男性中,伴有浅表或多发淋巴结肿大的纵隔肿块有助于LBL的诊断,但TdT反应阴性不能排除该诊断。T-LBL比B-LBL更常见。临床分期、免疫表型及Ki-67表达水平与LBL的预后密切相关。

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