恶性淋巴瘤合并乳糜胸一例

恶性肿瘤侵犯胸导管可引起乳糜胸,恶性淋巴瘤（ＭＬ）合并乳糜胸较罕见,现将１例报告如下：患者,女,４９岁,全身淋巴结无痛性肿大伴胸闷,咳嗽５天入院,无发热。既往曾于６个月前因全身淋巴结肿大４月入住我院,经颈部淋巴结活检诊断非霍奇金氏淋巴瘤（无裂细胞性）...     

44例儿童恶性淋巴瘤的免疫病理分类及临床病理分析

本文对４４例儿童恶性淋巴瘤进行免疫病理分类和临床病理分析。结果表明，临床主要表现浅表淋巴结肿大，消溲，苍白，发热及腹腔肿块，非何杰金氏淋巴瘤３３例，全部为弥漫 型，其中Ｂ淋巴瘤１８例，裂，无裂细胞性和无裂细胞性各７例；Ｔ淋巴瘤１４例，大部分为淋巴母细胞性；组织细胞性１例。     

骨髓细胞学检查对恶性淋巴瘤病理诊断、临床分期及预后价值

[目的]探讨骨髓细胞学检查对恶性淋巴瘤病理诊断和临床分期的价值.[方法]总结回顾101例恶性淋巴瘤患者的骨髓细胞学检查和临床分期结果.[结果]霍奇金淋巴瘤(HL)24例;非霍奇金淋巴瘤(NHL)77例.NHL分型:B细胞型49例,T细胞型26例和NK细胞型2例.恶性淋巴瘤的骨髓侵犯(BMI)32例(31.68%),其中恶性淋巴瘤性白血病(MLL)8例.HL的淋巴细胞削减型和混合细胞型;NHL的小淋巴细胞淋巴瘤,前B淋巴母细胞淋巴瘤和T淋巴母细胞淋巴瘤BMI多见.10例无明显浅表淋巴结肿大的NHL患者经骨髓活检确诊为BMI,分期则由原Ⅱ、Ⅲ期升为Ⅳ期.恶性淋巴瘤发展至MLL的间期＜3.5年,生存期＜28个月,预后不良.[结论]骨髓细胞学检查对恶性淋巴瘤的诊断和临床分期有重要价值,尤其对无淋巴结病理证据的患者可提供诊断依据,伴有BMI患者为临床晚期,可能进展为白血病.     

原发性睾丸恶性淋巴瘤8例报告

原发性睾丸恶性淋巴瘤(primary malignant lymphomaof the trestis PMLT)较少见,占睾丸肿瘤的1％～8％,我院自1988～1998年共收治8例,现报告如下: 本组8例,年龄48～71岁,平均年龄60岁,发生于右睾丸4例,左侧2例,双侧2例。首发症状均为无痛性睾丸肿大或变硬,1例有阴囊下坠感。体检除睾丸肿块外无异常发现。血常规均正常,胸片示肺未见异常,纵隔无淋巴结肿大。B超肝、脾未见异常,腹膜后淋巴结无肿大,病侧增大睾丸内有低回声灶或弥漫性低回声区。病理类型:7例B细胞淋巴瘤包括弥漫性小无裂细胞型3例,弥漫性大小细胞混合型2例,弥漫性大无裂细胞型2型。1例T细胞淋巴瘤为弥漫性多型细胞型。     

脾原发性恶性肿瘤8例报道

淮南矿二院自1977～1986年收集7例;蚌埠市二院1例,共8例。其中恶性淋巴瘤5例、血管肉瘤2例、恶性纤维组织细胞瘤1例。8例脾原发性恶性肿瘤年龄16～63岁,平均42岁,男性6例,女性2例。主要症状为脾渐进性不规则肿大,大多伴有左上腹胀痛,疲困,消瘦,贫血和近期发热等,脾血管肉瘤2例均发生自发性破裂。 病理 脾原发性恶性淋巴瘤粟粒结节型1例,巨块型2例,多肿块型2例。镜下均为滤泡性,3例大无裂细胞型,1例小无裂细胞型,1例裂无裂细胞型。2例脾血管肉瘤结节下极各有一裂口分别长2.8cm、2cm,切面蜂窝状。高度异形的内皮细胞沿血窦内侧壁生长突向血窦腔内形成花蕾样结构。     

CVBDP联合方案治疗20例恶性淋巴瘤

本院从 1997年起至今共收治 31例恶性淋巴瘤患者 ,2 0例可评价为ＣＶＢＤＰ方案联合化疗对象 ,现将治疗结果报告如下。材料与方法一、临床资料　恶性淋巴瘤患者 2 0例 ,男性 11例 ,女性9例 ,年龄 16～ 87岁 ,中位年龄 5 0岁。均经过淋巴结穿刺或活检方法病理确诊。病理类型均为非霍奇金恶性淋巴瘤(ＮＨＬ) ,其中低度恶性 :滤泡型小裂细胞 3例 ,中度恶性 :弥漫型小裂细胞 3例 ,混合细胞 1例 ,高度恶性 :组织细胞 2例 ,分类不明 11例。临床分期 :Ⅰ期 7例 ,Ⅱ期 5例 ,Ⅲ期 6例 ,Ⅳ期 2例。根据有无症状分Ａ、Ｂ二类 :Ａ(无症状 )为 11例 ,Ｂ(…     

胃MALT淋巴瘤免疫组化及病理形态定量研究

目的：探讨胃粘膜相关淋巴组织（ＭＡＬＴ）诊断与分类方法。方法：对１４例ＭＡＬＴ淋巴瘤进行免疫组化及病理形态定量研究。标本采用常规石蜡切片、ＨＥ染色及ＡＢＣ法免组化染色,并应用ＨＰＬＡＳ－１０００彩色图像分析系统对肿瘤细胞核的形态进行定量测定。结果：１４例胃ＭＡＬＴ淋巴瘤中ＣＣＬ细胞性９例。小无裂、大无裂、Ｔ免疫母细胞性各１例,ＣＣＬ合并大细胞性淋巴瘤２例。形态定量测定结果表明胃ＭＡＬＴ淋巴瘤与对照     

胃粘膜相关淋巴组织恶性淋巴瘤——11例临床病理及免疫组化研究

 本文报导11例胃粘膜相关淋巴组织恶性淋巴瘤(Mucosa AssociatedLymphoid Tissuse——Malignant Lymphoma,MALT—ML),临床特征病灶多局限于胃,以局部治疗为主。组织学:绝大多数属B淋巴瘤,以裂～无裂为主。淋巴上皮病变在活检中有诊断价值。1例富有组织细胞性ML。PL可以恶变为MALT—ML,预后较其它类型好。局部淋巴结转移出现假滤泡结构。Ci单克隆阳性率为64%。     

超声在评价颈部恶性肿大淋巴结中的应用

背景与目的：转移癌与淋巴瘤是引起颈部恶性淋巴结肿大的常见原因。本研究通过两者的二维超声和彩色多普勒血流显像的不同表现,探讨超声在颈部恶性淋巴结诊断中的价值。方法：取我院2006年1月～2008年12月间99例颈部恶性淋巴结肿大患者和40例健康人为观察对象,根据病理结果将患者分为54例转移癌组和45例淋巴瘤组。采用高频超声进行观察,包括肿大淋巴结的形态、长短径比值（L／S）、内部回声、淋巴门的情况、血流分布特征,并对测量参数进行统计学分析。结果：和良性淋巴结比较,恶性淋巴结的形态趋于圆形,L／S值小于对照组,以低回声为主,形态多样,易于融合,淋巴门缺失或移位,转移癌组可钙化和液化。转移癌组和淋巴瘤组声像图和血流特征存在差异,并可与良性淋巴结进行鉴别。结论：超声可作为评价颈部肿大恶性淋巴结的手段之一。     

两性腺原发性淋巴瘤26例临床病理分析

目的：探讨发生在睾丸、卵巢的原发性淋巴瘤的临床病理形态特点、临床分期和预后的关系。方法：对21例原发性睾丸恶性淋巴瘤、5例卵巢原发性恶性淋巴瘤进行组织形态学和免疫组织化学染色观察，依据WHO新分类进行分型．AnnArber（1971）国际分期法进行临床分期并结合文献对其临床病理特点及随访资料进行分析。结果：睾丸恶性淋巴瘤平均好发于60．70岁，随访21例患者中，弥漫大B细胞性淋巴瘤13例，中住生存期35．2个月，5年生存率38．5％；T细胞性淋巴瘤5例，中位生存期18．6个月，2年生存率40．0％，无5年生存率。B小淋巴细胞性淋巴瘤1例及淋巴浆细胞样淋巴瘤2例．5年生存率100％。就诊时病程处于Ⅰ期8例，中位生存期75．1个月。Ⅱ期8例．中位生存期36．5个月。Ⅲ、Ⅳ期5例，中位生存期8个月。卵巢原发性恶性淋巴瘤少见，病情进展迅速预后差。本组5例均为B细胞性淋巴瘤，其中小淋巴细胞性3例，淋巴浆细胞样淋巴瘤2例，Ⅰ期1例，Ⅱ期2例，Ⅲ期2例，其中2例失访，随诊3例均于1年内死亡。结论：睾丸原发性恶性淋巴瘤预后与临床分期、组织学分型关系密切，术后放、化疗有利于提高患者生存率，卵巢原发性恶性淋巴瘤预后差。     

Histological transformation of non-Hodgkin's lymphoma: a prospective study.

Forty-three lymph node biopsies were performed prior to retreatment in 30 unselected patients who had relapsed following chemotherapy for advanced non-Hodgkin's lymphoma of low grade histological type. Eight patients (27%) showed unequivocal evidence of transformation to a high grade variety of lymphoma. These included 4 out of 21 cases originally having had follicular lymphoma and 4 out of 9 cases having had diffuse lymphoma. In 2 further patients with follicular lymphoma, relapse was diagnosed following examination of the bone marrow and in one the tumor had clearly transformed. In 5 of the transformed lymphomas the cell type was predominantly centroblastic, in 2 immunoblastic and in the remaining 2 centrocytic (anaplastic). Five of the 9 cases developing high grade lymphoma have died after a median interval of 5 months from transformation, whereas only 3 of 23 cases showing no change are dead. In 4 patients low grade lymphoma persisted in the bone marrow at the time of nodal transformation. The clinical circumstances at the time of rebiopsy were unhelpful in predicting transformation.     

Mantle cell lymphoma: Natural history defined in a serially biopsied population over a 20-year period

Background: The histological, immunological and molecular characteristicsof mantle cell lymphoma have only recently been delineated.Amongst these characteristics possible factors of prognosticsignificance include histological growth pattern and blastoidchange. Patients and methods: 66 previously untreated casesof mantle cell lymphoma were identified in a retrospective analysis.In 50 cases serial biopsies had been taken during the diseaseandin 20 cases autopsies had been performed. Besides establishedfactors of prognostic significance, histological growth patternand blastoid change were examined. Results: 32 patients achievedan initial complete remission or good partial remission withmost cases relapsing or progressing within 2 years. The mediansurvival was 36 months. Factors predicting a poor outcome werehigh presenting stage, age >70, low sodium, low albumin andsplenomegaly. Blastoid transformation was also a poor prognosticfeature, occurring in 32% of cases during life and in 70% ofautopsies. Histological growth pattern had no influence on outcome.Conclusion: This study emphasises the difficulties in treatingmantle cell lymphoma and the high frequency and prognostic importanceof histological transformation. non-Hodgkin's lymphoma, mantle cell lymphoma, low grade B-cell lymphoma, histological transformation, centrocytic lymphoma, diffuse small cleaved cell lymphoma, mantle zone lymphoma     

Malignant lymphoma and cytology

Cytological diagnoses of lymph nodes in 300 cases by aspiration biopsies were compared with the final histological diagnoses. The rate of accurate cytological diagnoses were 73% of all 300 cases, and 64% of 100 cases of malignant lymphomas. The accuracy of cytological diagnosis of malignant lymphomas by the histologic types was the highest in diffuse lymphoma, relatively low in Hodgkin's disease and the lowest in follicular lymphoma. Imprints of lymph node biopsies from 20 cases of diffuse lymphoma, large cell type of the LSG classification were obtained at the time of diagnosis. By their differential cell counts the value of large lymphoid cells was 72 (33 to 98)%. In the patients with less than 75% of large lymphoid cells in imprints of lymph nodes seemed to tend to have disseminated disease at the time of diagnosis and leukemic manifestation at the last stage. Imprints of lymph node biopsies from 15 cases of diffuse lymphoma, pleomorphic type of the LSG classification at the time of diagnosis revealed large lymphoid cells of 41 (2-86)% and prolymphocytes of 41 (3-90)% by the differential cell counts of the imprints. Patients with more than 50% of large lymphoid cells were frequently suffered from fever and hepatosplenomegaly and had advanced stages at the time of diagnosis. They had poor responses to therapies resulted in unfavorable prognoses. Therefore, it was suspected that the cytological findings of lymph nodes in patients with malignant lymphomas of these types might be correlate to the clinical features and the prognosis.     

非霍奇金淋巴瘤细胞DNA含量测定的临床意义

研究非霍奇金淋巴瘤(NHL)中DNA含量和S期细胞比例(SPF)在非霍奇金淋巴瘤诊断和治疗中的意义。方法:35例NHL患者(NHL组)和10例淋巴结反应性增生患者(对照组)的新鲜淋巴组织,应用流式细胞技术检测其中DNA含量,并计算SPF。结果:35例NHL中异倍体出现率为37.10%(13/35)。10例反应性增生淋巴结组织中无异倍体出现。NHL组SPF均值为22.39%,对照组为9.88%(P<0.01)。NHL患者中低度恶性、中度恶性及高度恶性的SPF均值分别为9.10%、23.48%及29.16%。化疗有效者(完全缓解加部分缓解)SPF为25.63%,无效者为14.23%(P<0.05)。结果表明NHL中SPF的表达有随着恶性程度的增高而增加的趋势。肿瘤表现异倍体或高SPF者近期疗效好。结论:异倍体或高SPF有助于NHL的诊断并与疗效有关。     

Detection of somatic mutations of the bcl-2 oncogene in B cell lymphomas with the t(14;18)

The incidence of mutations within the first 582 bp of the open reading frame of the bcl-2 gene, has been investigated in presentation lymph node samples, from 7 cases with follicular non-Hodgkin's lymphoma (NHL), 1 case with centroblactic NHL, the DOHH, cell line derived from the immunoblastic transformation of a follicular NHL and one case with benign follicular hyperplasia. A total number of 43 point mutations within the examined portion of the bcl-2 gene were detected in the cases analysed including the DOHH, cell line. Similar analysis of peripheral blood lymphocytes from 2 normal individuals that lacked the t(14;18), revealed no mutations in one case and a single 101 bp A-->G transition in clone, in the other. Missense mutations were detected in 7/8 NHLs, the DOHH2 cell line and the case of benign follicular hyperplasia. There was a significantly higher frequency of mutations within the region corresponding to the BH1, one of the two known functional domains, of the bcl-2 protein. The same position, 445 bp of the bcl-2 gene, was found to be involved in missense mutations affecting the DOHH2 cell line and 3 cases with follicular NHL.     

Bone marrow in malignant lymphoma

The bone marrow examination is useful in the diagnosis and management of patients with malignant lymphoma. Demonstration of marrow lymphoma is dependent on obtaining adequate and properly prepared tissue for examination. The incidence and pattern of marrow disease differ for the various Working Formulation classes of non-Hodgkin's lymphoma (NHL); low grade and high-grade NHL have the highest incidence of marrow involvement at diagnosis. Hodgkin's disease involves the marrow less commonly than NHL and is found in a histologic environment similar to that in lymph node biopsies. Several benign lesions, including reactive lymphoid aggregates, granulomas, immunoblastic lymphadenopathy, and mast cell disease, must be distinguished from NHL or Hodgkin's disease in some instances.     

椎管原发性非何杰金氏恶性淋巴瘤临床与病理分析（附七例报告）

用免疫学及组织化学方法对７例原发于脊椎骨的非何杰金氏恶性淋巴瘤（ＮＨＬ）进行了回顾性研究。免疫学分型发现了Ｂ细胞型４例、Ｔ细胞型１例、混合型２例。组织学分型低度恶性２例、中度恶性３例、高度恶性２例。其中淋巴浆细胞样型预后最好。术前无一例考虑到本病。鉴别诊断时应除外骨髓瘤、尤文氏瘤、转移性未分化癌和小细胞性骨肉瘤。病变晚期区别是脊椎骨原发还是脊髓原发的ＮＨＬ较为困难。如能肯定为弥漫型或瘤细胞仅限于白质则对前者的确立有帮助。     

Correlation between histology and immunophenotype in a series of 322 cases of non-Hodgkin's lymphoma

The non-Hodgkin's lymphomas (NHL) are a heterogeneous group of lymphoid neoplasms displaying a wide variation in cell morphology, histological patterns, immunological phenotype and prognosis. In this paper we compare the results of phenotypic investigation of 322 tissue biopsies with the histology based on the Kiel classification. Immunological analysis revealed that 81 per cent of these tumours were of B cell origin, 12 per cent of T cell origin and the remaining 7 per cent could not be characterized as representing either cell lineage. This last group included a number of cases which had received a histological diagnosis of true histiocytic lymphoma. The original morphological diagnosis, based on routine haematoxylin and eosion sections correlated with the immunologically determined phenotype in 86 and 93 per cent of the T- and B-cell cases respectively. The B cell tumours were phenotypically heterogenous with respect to immunoglobulin (Ig) heavy chain and B lymphocyte subset marker expression. IgG was most often found associated with NHL of cb/cc histology and a small subgroup of lymphocytic NHL. IgA expression was uncommon and occurred in combination with IgD and G in three cases and alone in two cases of NHL. The most common immunoglobulin isotype expressed was IgM this isotype occurred with IgD most often in lymphocytic and centrocytic NHL and less often in tumours of cb/cc histology. Whilst greater than 90 per cent of the lymphocytic NHLs expressed the CD5 antigen, between 20 and 75 per cent of B-cell tumours of other histologies also expressed this epitope. The CD10 antigen and the epitope recognized by the monoclonal reagent FMC7 were widely distributed on tumour cells from all histologies. TdT expression commonly regarded as a marker for immature cells was found in one case of follicle centre cell lymphoma. All cases of T cell NHL displayed marked heterogeneity for both pan T and T subset antigens which is significant in terms of the routine diagnosis of T NHL and with regard to the rational classification of node based T NHL. Unlike resting peripheral blood T cells, MHC class II, OKT 10 and CD25 epitopes were expressed reflecting activation of tumour populations.(ABSTRACT TRUNCATED AT 400 WORDS)     

Ga-67 scintigraphy for the localization and staging of malignant lymphoma

Thirty-eight Ga-67 scintigraphies have been evaluated in regard to patients with an untreated malignant lymphoma or a recurrent lymphoma after a complete remission. Thirty-four studies (89%) showed positive findings. Waldeyer's ring and lymph node involvement were detected in 66% of the cases. The recurrent type was detected less often than the untreated malignant lymphoma, and there was no significant difference in detectability between Hodgkin's disease and non-Hodgkin's lymphoma. Although the malignancy grade for NHL did not affect the detectability, the intermediate and high grade NHLs tended to show a greater uptake than the low grade NHLs. The detectability was particularly good for neck and intrathoracic lymph nodes. Ga-67 scintigraphy tended to downgrade a malignant lymphoma to a lower stage, especially if in recurrence.     

Malignant lymphoma in the Miyazaki district: analysis of 237 biopsy cases

Pretreatment biopsy specimens of 237 consecutive patients with malignant lymphoma, who presented to us from 1979 to 1982, were reviewed and reclassified. According to the new classification proposed by the Lymphoma Study Group of Japan (LSG), there were 226 patients with non-Hodgkin's lymphoma (NHL) which was further classified as diffuse lymphoma (216 cases), follicular lymphoma (4 cases), mycosis fungoides (4 cases), and others (2 cases). The 216 cases of diffuse NHL were subdivided into small cell (2 cases), medium-sized cell (71 cases), mixed (7 cases), large cell (92 cases), pleomorphic (40 cases), lymphoblastic (3 cases), and Burkitt's type (1 case) lymphoma. Cell surface marker studies using conventional methods were performed on 65 NHL patients, of whom 45 showed T-cell marker and 11 B-cell marker, and 8 had neither marker. The average survival periods were 13.1 mo for 107 patients with NHL, 27.9 mo for those with mycosis fungoides and 70.0 mo for 10 patients with Hodgkin's disease. Patients with adult T-cell leukemia survived for an average of only 5.5 mo. Histologically diffuse pleomorphic type had the worst prognosis. T-cell lymphoma appeared to have a poorer prognosis than B-cell lymphoma.