原发性胃 T 细胞淋巴瘤的临床病理特征。

Clinicopathological characteristics of primary gastric T-cell lymphoma.

机构信息

Department of Pathology, Faculty of Medicine, Fukuoka University, Nanakuma 7-15-2, Jonan-ku, Fukuoka 814-0180, Japan.

出版信息

Histopathology. 2009 Dec;55(6):641-53. doi: 10.1111/j.1365-2559.2009.03430.x.

DOI:10.1111/j.1365-2559.2009.03430.x

PMID:20002766

Abstract

AIMS

To investigate the clinicopathological characteristics of 20 primary gastric T-cell lymphoma (GTCL) cases without human T-lymphotropic virus type I infection in Japan, a non-endemic area for coeliac disease.

METHODS AND RESULTS

Fifteen cases had no history of persistent diarrhoea or severe hypoproteinaemia. Histologically, 13 cases (65%) consisted of large cell lymphoma and seven (35%) were of medium-sized cells. Intraepithelial lymphoma cell invasion was found in three cases (15%). Two of 10 surgical cases (20%) showed intramucosal tumour cell spreading with enteropathy-like features. Helicobacter pylori CagA gene was detected in three of 10 cases (30%). The lymphoma cells of all 20 cases were positive for CD3 and/or TCRbetaF1 and negative for CD56. CD4- and CD8- lymphoma was found in 11 cases (55%), CD4+ lymphoma in seven (35%) and CD8+ lymphoma in two (10%). CD30+, CD5+ and CD25+ lymphomas were detected in nine (45%), 10 (50%) and 11 (55%) cases, respectively. Five-year survival of the 16 available cases was 54%. Early clinical stage and medium-sized cell lymphoma were significantly (P < 0.05) better prognostic factors.

CONCLUSIONS

Patients with GTCL exhibit distinct clinicopathological findings and prognoses from those with enteropathy-associated T-cell lymphomas. GTCL may be mainly derived from lamina propria and parafollicular T cells.

摘要

目的

研究日本 20 例原发性胃 T 细胞淋巴瘤（GTCL）病例的临床病理特征，这些病例均无人类 T 淋巴细胞病毒 I 型感染，日本为麸质肠病的非流行地区。

方法和结果

15 例患者无持续性腹泻或严重低蛋白血症病史。组织学上，13 例（65%）为大细胞淋巴瘤，7 例（35%）为中细胞淋巴瘤。3 例（15%）存在上皮内淋巴瘤细胞浸润。10 例手术病例中的 2 例（20%）表现出黏膜内肿瘤细胞扩散，具有肠病样特征。10 例中的 3 例（30%）检测到幽门螺杆菌 CagA 基因。20 例中的所有淋巴瘤细胞均对 CD3 和/或 TCRbetaF1 呈阳性，对 CD56 呈阴性。11 例（55%）为 CD4-和 CD8-淋巴瘤，7 例（35%）为 CD4+淋巴瘤，2 例（10%）为 CD8+淋巴瘤。9 例（45%）、10 例（50%）和 11 例（55%）分别检测到 CD30+、CD5+和 CD25+淋巴瘤。16 例可评估病例的 5 年生存率为 54%。早期临床分期和中细胞淋巴瘤是显著的（P < 0.05）更好的预后因素。