1例渗出性淋巴瘤报道及相关文献复习

doi:10. 3969 / j. issn. 2096-2266. 2020. 02. 015

大理大学学报 ›› 2020, Vol. 5 ›› Issue (2): 68-71.DOI: 10. 3969 / j. issn. 2096-2266. 2020. 02. 015

1例渗出性淋巴瘤报道及相关文献复习

王笑笑¹ ，高波² ，潘云^2*

（1.大理大学基础医学院，云南大理 671000；2.大理大学第一附属医院病理科，云南大理 671000）

收稿日期:2019-01-21 修回日期:2019-05-29 出版日期:2020-02-15 发布日期:2020-02-15
通讯作者: 潘云，教授，博士，E-mail：panyun09@163.com。
作者简介:王笑笑，硕士研究生，主要从事肿瘤分子病理学研究。
基金资助:
国家自然科学基金资助项目（81660037）；云南省高校分子病理重点实验室资助项目（云教科〔2016〕37号）；
大理大学肿瘤分子病理学创新团队资助项目（理大校发〔2019〕13号）

A Case Report of Effusion Lymphoma and Related Literature Review

Wang Xiaoxiao¹ , Gao Bo² , Pan Yun^2*

（1. Pre-clinical college, Dali University, Dali, Yunnan 671000, China; 2.Department of Pathology, The First Affiliated Hospital of Dali
University, Dali, Yunnan 671000, China）

Received:2019-01-21 Revised:2019-05-29 Online:2020-02-15 Published:2020-02-15

摘要/Abstract

摘要： 目的：通过对1例以胸膜腔积液为首发表现的淋巴瘤病例的报道，以期为渗出性淋巴瘤的诊治提供参考。方法：收集胸膜腔积
液制备细胞块，常规石蜡包埋苏木精-伊红（HE）染色，并行免疫组织化学染色（IHC）及原位杂交（ISH）检测，观察组织形态，评判免疫表
型，并随访。结果：胸水细胞块见大量异型淋巴样细胞，IHC示CD20、PAX5、BCL-2、BCL-6及MUM1阳性；CD45RO、Calretintin、
CD10、CD3、CK20、CK7、C-MYC及HHV-8阴性；Ki-67阳性指数为80%，ISH示EBER阴性，支持渗出性淋巴瘤，系弥漫大B细胞淋
巴瘤（DLBCL）继发渗出，非生发中心型（Non-GCB），患者病情恶化，于确诊后2月死亡。结论：渗出性淋巴瘤为一类较为少见的淋巴瘤，
淋巴瘤患者一旦出现浆膜腔恶性积液，预示预后不良。诊断上须与炎性渗出、转移性肿瘤等鉴别，免疫组化等检测有助于确诊。

关键词: 渗出性淋巴瘤, 原发与继发, 临床诊治

Abstract: Objective: A case of lymphoma with the first manifestation of pleural effusion was reported to provide a reference for the
diagnosis and treatment of effusion lymphoma. Methods: Pleural effusion was collected to make cell blocks, which routinely stained
with HE, immunohistochemical staining（IHC）and in situ hybridization（ISH）detection were performed to observe tissue morphology
and evaluate immunophenotype. We followed up the patient subsequently. Results: A lot of atypical lymphoid cells were found in
pleural effusion. The results of IHC staining showed as follows: CD20, PAX5, BCL-2, BCL-6 and MUM1 were positive, while the
CD45RO, Calretintin, CD10, CD3, CK20, CK7, C-MYC and HHV-8 were negative; Ki-67 positive index was 80%. In situ
hybridization showed that the tumor cells nuclei were negative for EBER. The patient was diagnosed as diffuse large B-cell lymphoma
with secondary exudation and non-germinal central type（Non-GCB）. The patient deteriorated and died two months after diagnosis.
Conclusion: Effusion lymphoma is a rare type of lymphoma. Once malignant effusion in serous cavity occurs in patients with
lymphoma, the prognosis is poor. This disease should be differentiated from inflammatory exudation and metastatic tumors, and IHC is
useful for the diagnosis.

Key words: effusion lymphoma, primary and secondary, clinical diagnosis and treatment