【摘要】 目的探讨原发性宫颈淋巴瘤与淋巴瘤样病变的诊断与鉴别诊断特点。方法收集3例原发性宫颈弥漫大B细胞淋巴瘤与4例宫颈淋巴瘤样病变,从病理特点、免疫组化表达及临床资料等方面进行回顾性总结分析。结果宫颈淋巴瘤与淋巴瘤样病变均为具有异型性的中等大小或体积较大的B细胞致密增生浸润(CD2+0,CD7+9a,CD-3),细胞增生活跃,核分裂象多见。细胞增生指数Ki-67和p53蛋白的表达在两种病变中差异无统计学意义,而κ、λ的表达与分布在两种病变有所不同,3例宫颈淋巴瘤均表现为κ阳性而λ阴性,而宫颈淋巴瘤样病变κ、λ均为阳性且κ、λ阳性细胞的数量差异无统计学意义;PCR-IgH基因重排检测证实IgH基因在宫颈淋巴瘤发生了单克隆重排,而淋巴瘤样病变没有。结论宫颈淋巴瘤样病变在病理组织学、免疫表达方面与宫颈淋巴瘤相似,PCR-IgH重排和免疫组化κ、λ的标记检测有助于宫颈B细胞淋巴瘤和淋巴瘤样病变的诊断和鉴别诊断。更多还原

【Abstract】 Objective To investigate the pathological features and their differential diagnosis of primary lymphoma and lymphoma-like lesion of the cervix. Methods Three cases of primary cervical lymphoma and four cases of cervical lymphoma-like lesion were retrospectively studied by analyzing their pathological features, immunohistochemical expression and clinical manifestation, and their therapeutic results were followed up. Results The histopathological and immunohistochemical analysis of the cervical biopsy of all cases showed a dense large to medium-sized atypical B-cell infiltration (B-cell marker CD20 and CD79a positive and T-cell marker CD3 negative). The cells proliferate actively with mitosis activity. There was no difference in the expression of the proliferation index Ki-67 and p53 protein between the lymphoma cases and lymphoma-like lesions. The difference lies in the expression κ and λ. κ positive and λ negative were found in all cervical lymphoma cases. In contrast, double expression of κ and λ were shown in cervical lymphoma-like lesions, and the percentage of κ and λ positive cells were similar. The further PCR-IgH gene rearrangement analysis demonstrated that the monoclonal rearrangement of IgH gene was occurred in cervical lymphoma cases not in lymphoma-like lesions. Conclusion Cervical lymphoma-like lesions mimic cervical lymphoma in histopathological feasures and immunohistochemical expression. PCR-IgH gene rearrangement analysis and immunohistochemical detection of κ and λ protein are helpful to differential diagnosis between B-cell lymphoma and lymphoma-like lesion of the uterine cervix.更多还原