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目的:探讨恶性组织细胞增生症瘤细胞的属性,EB病毒感染的情况及其临床病理特点。方法:收集33例以往诊断为恶组的尸检病例及相关临床资料,并利用组织芯片技术将不同组织集成在一张切片上。免疫组化采用LsAB法。一抗选用CD4、CD8、CD20、CD45RO、CD56、CD3ε、CD30、CD68、TIA-1及GranzymeB。DNA-RNA原位杂交检测EB病毒编码的小分子mRNA。结果:33例恶组中,排除不符合传统恶组诊断标准的4例,选择其中29例作为研究对象。检测结果示29例中有28例属外周T细胞淋巴瘤,其中皮下脂膜炎样T细胞淋巴瘤3例、肠道T细胞淋巴瘤1例,间变性大细胞淋巴瘤1例;16/28例为EBER1/2阳性;余1例为恶组样B细胞性血管内淋巴瘤。结论:恶性组织细胞增生症是一组异质性淋巴细胞增生性疾病。绝大多数瘤细胞来源于细胞毒性,T细胞或NK细胞(28/29),少数来源于B淋巴细胞(1/29),未发现组织细胞源性的肿瘤。
Objective: To investigate the characteristics of malignant histiocytosis tumor cells, Epstein-Barr virus infection and its clinicopathological features. Methods: The autopsy cases and related clinical data of 33 cases previously diagnosed as malignant group were collected. Tissue microarray was used to integrate different tissues into a single slice. Immunohistochemistry using LsAB method. The primary antibodies were CD4, CD8, CD20, CD45RO, CD56, CD3ε, CD30, CD68, TIA-1 and GranzymeB. Detection of Epstein-Barr virus-encoded small molecule mRNA by DNA-RNA in situ hybridization. Results: Among the 33 cases of malignant group, 4 cases that did not meet the diagnostic criteria of traditional malignant group were excluded and 29 cases were selected as the study object. Twenty-nine of the 29 patients showed peripheral T-cell lymphoma, including 3 cases of subcutaneous panniculitis-like T-cell lymphoma, 1 case of intestinal T-cell lymphoma and 1 case of anaplastic large cell lymphoma. Cases were EBER1 / 2 positive; the remaining 1 case of malignant group B-cell intravascular lymphoma. Conclusion: Malignant histiocytosis is a heterogeneous group of lymphoproliferative diseases. The vast majority of tumor cells derived from cytotoxic T cells or NK cells (28/29), a small number from B lymphocytes (1/29), found no tissue-derived tumors.