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目的探讨CD20~+T/NK细胞淋巴瘤的临床病理特征、诊断与鉴别诊断。方法收集2例CD20~+T/NK细胞淋巴瘤,回顾性分析其临床病理资料,并复习文献。结果例1扁桃体肿物。镜下见扁桃体黏膜组织中有弥漫浸润的淋巴样细胞,细胞体积大,异型明显,部分区域细胞呈窦隙状生长。免疫组化:CD2、CD3、CD5、CD30和CD20(+),而PAX-5、CD79a、ALK、CD15和CD10(-),Ki-67阳性指数70%。EBER原位杂交(-)。病理诊断:CD20+间变型大细胞淋巴瘤。例2鼻咽部肿物。病理诊断:结外鼻型NK/T细胞淋巴瘤(ENK/TCL),CD20~-。放、化疗后16个月出现胸壁皮肤肿物,活检见皮下纤维脂肪中有灶片状浸润的淋巴样细胞,细胞中等大小,核形欠规则。免疫组化:CD2、CD3、CD43、CD56、CD20和Gram-B(+),而PAX-5、CD79a、TIA-1和穿孔素(-),Ki-67阳性指数90%。EBER原位杂交(+)。病理诊断:CD20+ENK/TCL。结论 CD20+T细胞淋巴瘤少见,诊断困难,易误诊。诊断与鉴别诊断依靠组织形态学、免疫组化和分子生物学特征。
Objective To investigate the clinicopathological features, diagnosis and differential diagnosis of CD20 ~ + T / NK cell lymphoma. Methods Two cases of CD20 ~ + T / NK cell lymphoma were collected. The clinical and pathological data were retrospectively reviewed and the literature reviewed. Results Example 1 tonsil tumor. Microscope see tonsil mucosal tissue diffuse infiltration of lymphoid cells, large cells, allotypes obvious, part of the cells were sinusoidal growth. Immunohistochemistry: CD2, CD3, CD5, CD30 and CD20 (+), while PAX-5, CD79a, ALK, CD15 and CD10 (-), Ki-67 positivity index 70%. EBER in situ hybridization (-). Pathological diagnosis: CD20 + anaplastic large cell lymphoma. Example 2 nasopharyngeal tumor. Pathological diagnosis: Extranodal nasal type NK / T cell lymphoma (ENK / TCL), CD20 ~ -. Release, 16 months after chemotherapy, chest wall skin tumor, biopsy see subcutaneous fat in the fibrous infiltration of lymphoid cells, the medium-sized cells, nuclear-deficient rules. Immunohistochemistry: CD2, CD3, CD43, CD56, CD20 and Gram-B (+), while PAX-5, CD79a, TIA-1 and perforin (-), Ki- 67 positivity index 90%. EBER in situ hybridization (+). Pathological diagnosis: CD20 + ENK / TCL. Conclusion CD20 + T-cell lymphoma is rare and difficult to diagnose and is easily misdiagnosed. Diagnosis and differential diagnosis rely on histomorphology, immunohistochemistry and molecular biology.