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目的探讨原发性淋巴结边缘区 B 细胞淋巴瘤(NMZL)的形态特点、免疫表型特征、鉴别诊断及预后。方法对10例原发于淋巴结的 NMZL 进行光镜观察,免疫组织化学 EliVision 法染色,参照 Ann Arbor 临床分期,并进行了3～29个月随访。结果 10例就诊时均精神状况良好,但大多(6/7)临床分期较高(Ⅱ或Ⅲ期)。NMZL 大多呈模糊结节的生长方式(5/10)。细胞的形态以中心细胞样细胞为主(7/10),少数以单核细胞样细胞为主(2/10)或小淋巴细胞样细胞为主(1/10)。大多(8/10)伴有浆样细胞和(或)浆细胞。肿瘤细胞增殖指数范围5%～50%。7例滤泡树突细胞(FDC)网以萎缩变小为主,3例 FDC 网不同程度增生。7例得到随访(平均12个月),其中6例临床分期为Ⅱ或Ⅲ期。3例存活1年以上。结论原发性 NMZL 少见,肿瘤细胞生长方式独特,细胞形态多以生发中心细胞样细胞为主。需与淋巴浆细胞淋巴瘤、结外边缘区淋巴瘤累及淋巴结及 T 区增生等鉴别。肿瘤细胞较易播散,诊断时大多临床分期较高,预后可能较差。
Objective To investigate the morphological characteristics, immunophenotypic features, differential diagnosis and prognosis of primary lymph node border zone B-cell lymphoma (NMZL). Methods 10 cases of primary nodal lymph nodes were observed by light microscopy and immunohistochemical EliVision staining. The clinical stage was Ann Arbor. The follow-up was performed from 3 to 29 months. Results All the 10 cases were in good mental condition at the time of visit, but the clinical stage was mostly (6/7) (Stage Ⅱ or Ⅲ). NMZL mostly fuzzy nodule growth (5/10). The morphology of the cells mainly consisted of centrocyte-like cells (7/10). A few of them were mainly mononuclear cells (2/10) or small lymphoid cells (1/10). Mostly (8/10) with plasma cells and / or plasma cells. Tumor cell proliferation index range of 5% to 50%. 7 cases of follicular dendritic cells (FDC) network to shrink shrink smaller, 3 cases of FDC network proliferation to varying degrees. Seven patients were followed up (average 12 months), of which 6 were stage Ⅱ or Ⅲ clinical stage. 3 cases survived for more than 1 year. Conclusions Primary NMZL is rare, the growth of tumor cells is unique, and the cell morphology is mainly dominated by germinal center cell-like cells. With lymphoplasmacytic lymphoma, extranodal marginal zone lymphoma involving lymph nodes and T zone proliferation identification. Tumor cells more easily disseminated, most of the clinical stage of diagnosis is higher, the prognosis may be poor.