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目的 提高对脾边缘带淋巴瘤 (SMZL)的认识和诊疗水平。方法 报告 1例典型SMZL ,外周血、骨髓及脾脏标本分别采用光镜、相差显微镜、扫描电镜、免疫组化染色、流式细胞术、G显带核型分析及PCR技术研究其肿瘤细胞的生物学特征。结果 本例患者肿瘤细胞为B淋巴细胞 ,不伴有绒毛 ,表达CD2 0 、HLA DR、CD4 5RA和bcl 2 ,无异常核型 ,肿瘤细胞主要浸润脾脏白髓致边缘带明显扩大 ,脾门淋巴结受累。骨髓和外周血与脾脏有相同的单克隆IgH重排基因 ,治疗 7个月后转为多克隆重排。结论 脾大、外周血或骨髓淋巴细胞比例增高而无淋巴结肿大和白细胞增高患者应疑及SMZL,单克隆IgH基因重排有助于SMZL的诊断 ,对可疑病例应尽早切脾以明确诊断及防止恶性转化。
Objective To improve the understanding and diagnosis of splenic margin lymphoma (SMZL). Methods A typical SMZL, peripheral blood, bone marrow and spleen specimens were examined by light microscopy, phase contrast microscopy, scanning electron microscopy, immunohistochemistry, flow cytometry, G-banding karyotype analysis and PCR techniques to study the biological characteristics of tumor cells Learn characteristics. Results In this case, the tumor cells were B lymphocytes without villus and expressed CD20, HLA DR, CD4 5RA and bcl2. There was no abnormal karyotype. The tumor cells mainly infiltrated the white pulp of the spleen and caused significant enlargement of the marginal zone. The splenic lymph nodes Involved. Bone marrow and peripheral blood and spleen have the same monoclonal IgH rearrangement gene, 7 months after treatment into polyclonal rearrangements. Conclusion Splenomegaly, peripheral blood or bone marrow lymphocytes increased without lymph node enlargement and leukocytosis should be suspected SMZL, monoclonal IgH gene rearrangement contribute to the diagnosis of SMZL, as soon as possible in patients with suspected splenectomy to confirm the diagnosis and prevention Malignant transformation.