【摘要】 目的探讨肾移植后淋巴组织增生性疾病(PTLD)的临床病理学特征,提高对该疾病的诊治水平。方法报道2例肾移植后PTLD,采用CD20、CD3、CD45RO、CD79a、bcl-6、CD10、Mum-1和Ki-67等抗体进行免疫组化染色,并进行EBV原位杂交检测,同时结合文献复习进行讨论。结果 2例患者肾移植术后均采用三联免疫抑制疗法,PTLD诊断时间分别为3年和16年。2例病理组织学类型均为单型性PTLD,其中1例为外周T细胞性淋巴瘤,1例为弥漫性大B细胞性淋巴瘤,均无特异性临床表现。确诊后均将免疫抑制剂减量,其中1例辅以利妥昔单抗治疗。1例患者确诊后短期内死亡,另1例患者生存。结论 PTLD是发生在器官移植后具有独特形态和临床特征的淋巴组织增生性疾病,预后较差,采用免疫抑制剂减量和抗利妥昔单抗治疗有效。更多还原

【Abstract】 Objective To study the clinicopathologic characteristics of post-transplantation lymphoproliferative disorders( PTLD) following renal transplantation. Methods Two cases of PTLD following renal transplantation were collected,immunohistochemical study for CD20,CD3,CD45 RO,CD79a,Bcl-6,CD10,Mum-1 and Ki-67 was performed,in-situ hybridization was used to detect EBV. Results All 2 cases had received 3-drug-immunosuppression after transplantation. The duration between renal transplantation and diagnosis of PTLD was 3 years and 16 years,respectively,and both of the patients suffered from monomorphic PTLD( one was peripheral T cell lymphoma,and the another was diffuse large B cell lymphoma). Both patients received therapy with dosage reduction of immunosuppression and one with rituximab. Conclusion PTLD is a lymphoproliferative disease with distinctive morphology and clinical characteristics.The prognosis of PTLD is poor and the modalities of treatment include reduction of immunosuppression or antibody Rituximab.更多还原