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[睾丸原发性弥漫性大B细胞淋巴瘤:14例临床病理研究]

[Primary diffuse large B-cell lymphoma of testis: a clinicopathologic study of 14 cases].

作者信息

Li Dan, Mi Can, Zhao Yong, Wang Ya-lan, Ma Ying, Li Yuan-yuan, Xiang Mei-huan

机构信息

Department of Pathology, College of Basic Medicine, Chongqing University of Medical Science, Chongqing 400016, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2007 Jul;36(7):461-5.

Abstract

OBJECTIVE

To study the clinicopathologic features, immunohistochemical findings and prognosis of primary diffuse large B-cell lymphoma (DLBCL) of testis.

METHODS

Fourteen cases of primary DLBCL of testis, diagnosed according to the 2001 World Health Organization staging standards for hematopoietic and lymphoid tumors, were retrospectively studied. Immunohistochemical study was performed and follow-up information analyzed.

RESULTS

The median age of the patients was 62 years. There were 10 patients in stage I, 3 in stage II and 1 in stage IV. Follow-up information was available in 11 patients (78.6%). Three of which were still alive and eight died (with duration of survival ranging from 5 to 19 months). The patients usually presented with unilateral painless enlargement of testis. Histologically, the lymphoma cells of all cases showed a centroblastic appearance. One case belonged to the germinal center B cell-like subtype on immunohistochemical study, while the remaining 13 cases were classified as non-germinal center B cell-like subtype. Ten of the 14 cases (71.4%) showed overexpression of p53 protein. Most cases demonstrated high proliferation index. Six of the 14 cases (42.9%) were positive for bcl-2 protein. The overall 1-year, 2-year and 5-year survival rates were 45.5%, 17.0% and 17.0%, respectively.

CONCLUSIONS

Most cases with primary DLBCL of testis were of peripheral activated B-cell origin. The prognosis is usually not favorable, with propensity of local relapse and systemic dissemination. Accurate pathologic diagnosis relies on detailed histologic examination and immunohistochemical study.

摘要

目的

研究睾丸原发性弥漫性大B细胞淋巴瘤(DLBCL)的临床病理特征、免疫组化结果及预后。

方法

回顾性研究14例根据2001年世界卫生组织造血与淋巴组织肿瘤分期标准诊断的睾丸原发性DLBCL病例。进行免疫组化研究并分析随访信息。

结果

患者的中位年龄为62岁。Ⅰ期10例,Ⅱ期3例,Ⅳ期1例。11例患者(78.6%)有随访信息。其中3例仍存活,8例死亡(生存时间为5至19个月)。患者通常表现为单侧睾丸无痛性肿大。组织学上,所有病例的淋巴瘤细胞均呈中心母细胞样外观。免疫组化研究显示1例属于生发中心B细胞样亚型,其余13例归类为非生发中心B细胞样亚型。14例中的10例(71.4%)显示p53蛋白过表达。大多数病例显示高增殖指数。14例中的6例(42.9%)bcl-2蛋白呈阳性。总体1年、2年和5年生存率分别为45.5%、17.0%和17.0%。

结论

大多数睾丸原发性DLBCL病例起源于外周活化B细胞。预后通常不佳,有局部复发和全身播散倾向。准确的病理诊断依赖于详细的组织学检查和免疫组化研究。

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