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[鼻腔鼻窦结外非霍奇金淋巴瘤的临床病理分析:附15例报告]

[Clinicopathologic analysis of extranodal non-hodgkin lymphoma of the sinonasal cavities: a 15-case report].

作者信息

Zhang Y H, Duan Q C, Zuo Q, Du C, Xie L F, Zhu L

机构信息

Department of Otorhinolaryngology, Beijing University Third Hospital, Beijing, 100191, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 5;31(21):1653-1657. doi: 10.13201/j.issn.1001-1781.2017.21.008.

Abstract

To investigate the clinical manifestation, imaging and histological features of different histological subtypes of non-Hodgkin's lymphoma of nasal cavity and paranasal sinuses.Fifteen NHL patients of the sinonasal region were collected from the Department of Otolaryngology of Peking University Third Hospital from 2010 to 2016. HE staining and immunohistochemical staining were performed. The clinical characteristics and imaging features of different subtypes were described and analyzed.:We analyzed a total of 6 patients with localized sinonasal diffuse large B cell lymphoma and 9 patients with localized sinonasal extranodal NK/T cell lymphoma. The age distribution for these two subtypes is very distinct. The median age of the patients with localized sinonasal extranodal NK/T cell lymphoma was 39 years. There were 5 males and 4 females. Nine sinonasal NHLs were NK/T-cell lymphoma, nasal type, all of which were infected with EBV. The median age of the patients with localized sinonasal diffuse large B cell lymphoma was 64 years. There were 3males and 3 females. Symptoms for patients with SN-DLBCL and SN-ENKTL were significantly different in epiphora, proptosis, diplopia and nasal congestion (=0.18, 0.004, 0.18, 0.18). Imaging features for patients with SN-DLBCL and SN-ENKTL were significantly different in tumor extended to orbit and inferior turbinate (>0.05). Positive staining for CD 56 was detected in 9 patients, for CD 3 in 9 patients, for EBER in 9 patients. The Hans algorithm identified 1 patient with the germinal center B-cell (GCB) subtype and 5 with the non-GCB subtype.Compared with the control group, the observation group was significantly better than the control group ( < 0.01).Early symptoms of epiphora, proptosis, diplopia, and images finding with orbital invasion should be highly suspected of diffuse large B cell lymphoma. Positive staining for CD 56 and EBER were detected in all patients with extranodal NK/T cell lymphoma, and positive staining for CD20 was detected in all patients with SN-DLBCL.

摘要

探讨鼻腔及鼻窦非霍奇金淋巴瘤不同组织学亚型的临床表现、影像学及组织学特征。收集2010年至2016年北京大学第三医院耳鼻咽喉科15例鼻窦区非霍奇金淋巴瘤患者。进行苏木精-伊红(HE)染色及免疫组化染色。描述并分析不同亚型的临床特征及影像学特征。我们共分析了6例局限性鼻窦弥漫大B细胞淋巴瘤患者和9例局限性鼻窦结外NK/T细胞淋巴瘤患者。这两种亚型的年龄分布差异很大。局限性鼻窦结外NK/T细胞淋巴瘤患者的中位年龄为39岁。男性5例,女性4例。9例鼻窦非霍奇金淋巴瘤为鼻型NK/T细胞淋巴瘤,均感染EB病毒。局限性鼻窦弥漫大B细胞淋巴瘤患者的中位年龄为64岁。男性3例,女性3例。鼻窦弥漫大B细胞淋巴瘤(SN-DLBCL)和鼻窦结外NK/T细胞淋巴瘤(SN-ENKTL)患者在溢泪、眼球突出、复视和鼻塞方面的症状有显著差异(P=0.18、0.004、0.18、0.18)。SN-DLBCL和SN-ENKTL患者在肿瘤累及眼眶和下鼻甲方面的影像学特征有显著差异(P>0.05)。9例患者CD 56染色阳性,9例患者CD 3染色阳性,9例患者EBER染色阳性。汉斯算法鉴定出1例生发中心B细胞(GCB)亚型患者和5例非GCB亚型患者。与对照组相比,观察组明显优于对照组(P<0.01)。溢泪、眼球突出、复视等早期症状以及眼眶侵犯的影像学表现应高度怀疑弥漫大B细胞淋巴瘤。所有结外NK/T细胞淋巴瘤患者CD 56和EBER染色阳性,所有SN-DLBCL患者CD20染色阳性。

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