论文部分内容阅读
目的探讨原发性中枢神经系统弥漫性大B细胞性淋巴瘤(PCNS-DLBCL)围血管生长的机制。方法对22例PCNS-DLBCL进行临床、放射和病理观察及随访,免疫组化EnVision法行XBP1、CD44和IL-4表达分析,以17例淋巴结弥漫性大B细胞性淋巴瘤和10例胶质母细胞瘤为对照。结果 22例PCNS-DLBCL年龄41～69岁,平均年龄56岁,男女之比为1.4∶1。CT多表现为占位性病变;MRI显示T1加权相低信号,T2加权相等或稍高信号,增强扫描有不均匀强化。镜检示肿瘤细胞大多围绕血管生长形成袖套样外观,实性区域仍伴有围血管生长特点。免疫组化示围血管生长的肿瘤细胞XBP1、IL-4和CD44强(+),表达率分别为95.5%、86.3%和77.3%,GFAP和CD34(-),与对照组淋巴结弥漫性大B细胞性淋巴瘤和胶质母细胞瘤比较差异极显著(P<0.01)。结论 PCNS-DLBCL具有特征性的临床病理特征,肿瘤细胞围血管生长显示独特的形态特点,与XBP1、CD44和IL-4的表达增高关系密切。
Objective To investigate the mechanism of perivascular growth in primary central nervous system diffuse large B cell lymphoma (PCNS-DLBCL). Methods 22 cases of PCNS-DLBCL were observed by clinical, radiological and pathological examination. The expression of XBP1, CD44 and IL-4 in EnVision immunohistochemical method was analyzed. Twenty-seven cases of diffuse large B-cell lymphoma and 10 cases of glial Bleb is the control. Results 22 cases of PCNS-DLBCL aged 41 to 69 years, mean age 56 years old, male to female ratio was 1.4: 1. CT showed multiple lesions; MRI showed T1 weighted phase low signal, T2 weighted equal or slightly higher signal, enhanced scan with uneven enhancement. Microscopic examination of tumor cells mostly around the blood vessels to form a sleeve-like appearance, solid region is still associated with peripheral vascular growth characteristics. Immunohistochemistry showed that the expression of XBP1, IL-4 and CD44 in peripheral blood was significantly increased (95.5%, 86.3%, 77.3%, GFAP and CD34 (-)) Cell lymphoma and glioblastoma were significantly different (P <0.01). Conclusion PCNS-DLBCL has the characteristic clinicopathological features. The growth of tumor cells around the tumor cells shows unique morphological characteristics, which are closely related to the increased expression of XBP1, CD44 and IL-4.