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[乳腺原发性非霍奇金恶性淋巴瘤。14例病例的解剖病理学诊断]

[Primary non-Hodgkin's malignant lymphoma of the breast. Anatomopathologic diagnosis of 14 cases].

作者信息

Prévot S, Hugol D, Le Tourneau A, Audouin J, Diebold J

机构信息

Laboratoire J Delarue, Service central d'anatomie et de cytologie pathologiques, Hôtel-Dieu, Paris, France.

出版信息

Bull Cancer. 1990;77(2):123-36.

PMID:2180503
Abstract

Fourteen primary non-Hodgkin's malignant lymphoma (ML) of the breast observed between 1985 and 1989 were reviewed. Using the Ann Arbor staging system, 5 of these ML were at clinical stage IE, 2 at stage IIE, and only one was at clinical stage IVE (the ML involved both breasts of a young woman after her third post-partum and she died quickly), staging was not available in 6 cases. At the time of physical examination, the diagnosis of ML was not suspected. When possible, it was done or-suspected before surgery, studying fine needle aspiration cytology (4 cases) or drill biopsy (2 cases). Cytological examination was also useful to make the difference between primary large cells T ML and granulocytic sarcomas which sometimes occur before the acute myeloid leukemia and/or the blast crisis of a myeloproliferative disorder. According to the Kiel histopathological classification (updated in 1988), 78.5% of these ML were of great malignancy, more than half of them being polymorphous centroblastic B ML. Only one of them was an angiocentric pleomorphic T lymphoma of great malignancy. None of the ML of low malignancy, all of the follicular type, was a MALT (Mucosa Associated Lymphoid Tissue) ML, as described by Isaacson. Intra-epithelial lymphocytes were observed in 6 of the ML of great malignancy; but in 2 cases, they were T lymphocytes and these lympho-epithelial lesions could not be interpreted as an argument for the MALT nature of these ML. None of our cases were associated with a ML from another MALT site.

摘要

回顾了1985年至1989年间观察到的14例原发性乳腺非霍奇金恶性淋巴瘤(ML)。采用Ann Arbor分期系统,其中5例ML处于临床IE期,2例处于IIE期,仅1例处于临床IVE期(该ML累及一名年轻女性产后第三次时的双侧乳房,她很快死亡),6例无法分期。体格检查时,未怀疑有ML的诊断。可能的情况下,在手术前通过细针穿刺细胞学检查(4例)或钻取活检(2例)做出诊断或怀疑诊断。细胞学检查对于区分原发性大细胞T ML和粒细胞肉瘤也很有用,粒细胞肉瘤有时发生在急性髓系白血病和/或骨髓增殖性疾病的原始细胞危象之前。根据1988年更新的Kiel组织病理学分类,这些ML中有78.5%具有高度恶性,其中一半以上为多形性中心母细胞B ML。其中只有1例是高度恶性的血管中心性多形性T淋巴瘤。所有低恶性的ML均为滤泡型,均不是Isaacson所描述的MALT(黏膜相关淋巴组织)ML。在6例高度恶性的ML中观察到上皮内淋巴细胞;但在2例中,它们是T淋巴细胞,这些淋巴上皮病变不能被解释为这些ML具有MALT性质的证据。我们的病例均未与来自另一个MALT部位的ML相关。

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