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原发性肠道结外NK/T细胞淋巴瘤,鼻型的临床病理及免疫表型特征

Clinicopathologic and Immunophenotypic Features of Primary Intestinal Extranodal NK/T-Cell Lymphoma, Nasal Type.

作者信息

Fang Jian-Chen, Xia Zhao-Xia, Wang Chun-Nian, Li Zheng

机构信息

Ningbo Diagnostic Pathology Center, Ningbo, China Ningbo Lihuili Hospital, Ningbo, China

Ningbo Diagnostic Pathology Center, Ningbo, China Ningbo Lihuili Hospital, Ningbo, China.

出版信息

Int J Surg Pathol. 2015 Dec;23(8):609-16. doi: 10.1177/1066896915595863. Epub 2015 Jul 15.

Abstract

Primary intestinal extranodal NK/T-cell lymphoma, nasal type, is an extremely rare type of lymphoma with poor prognosis, and early diagnosis is challenging. Here we have investigated the clinicopathologic features and immunophenotypes of primary intestinal extranodal NK/T cell lymphomas, nasal type, in 10 Chinese patients. Complete staging data showed that 1 patient had stage I disease, 7 had stage II disease, and 2 had stage III disease. Eight of 10 (80%) patients had lymphadenopathy and none had bone marrow involvement. All the patients had a low International Prognostic Index (IPI) score (<3) at presentation. The median age at the time of diagnosis was 37.5 years (range = 24-68 years). All the patients died within 21 months, and the median survival time was 9.5 months (range = 2-21 months). So the conventional IPI and staging system failed to predict the outcome of the patients with the lymphoma. Except for the size of tumor cells, most of the morphologic features of the cases we studied were similar to those involving the midline facial tissue. Immunohistochemical studies showed the expression of cytotoxic markers (100%), CD2 (100%), CD3ε (90%), CD56 (80%), P53 (60%), CD30 (30%), LMP1 (30%), EBNA3A (0%). Nine cases (90%) highly expressed Ki-67. In situ hybridization for Epstein-Barr virus-encoded small RNA was positive in all cases.

摘要

鼻型原发性肠道结外NK/T细胞淋巴瘤是一种极其罕见的淋巴瘤,预后较差,早期诊断具有挑战性。在此,我们对10例中国患者的鼻型原发性肠道结外NK/T细胞淋巴瘤的临床病理特征和免疫表型进行了研究。完整的分期数据显示,1例患者为I期疾病,7例为II期疾病,2例为III期疾病。10例患者中有8例(80%)有淋巴结病,无一例有骨髓受累。所有患者初诊时国际预后指数(IPI)评分均较低(<3)。诊断时的中位年龄为37.5岁(范围 = 24 - 68岁)。所有患者均在21个月内死亡,中位生存时间为9.5个月(范围 = 2 - 21个月)。因此,传统的IPI和分期系统未能预测该淋巴瘤患者的预后。除肿瘤细胞大小外,我们研究的病例的大多数形态学特征与累及中线面部组织的病例相似。免疫组织化学研究显示细胞毒性标志物表达(100%)、CD2表达(100%)、CD3ε表达(90%)、CD56表达(80%)、P53表达(60%)、CD30表达(30%)、LMP1表达(30%)、EBNA3A表达(0%)。9例(90%)患者Ki-67高表达。所有病例中爱泼斯坦 - 巴尔病毒编码小RNA的原位杂交均为阳性。

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