在暴露于外部环境的器官中,非新生性B细胞主导的淋巴细胞增殖模仿淋巴瘤:潜在的诊断陷
Yue Fan1, Benjamin Ka Seng Thong2, Ouyang Binshen1
1Department of Pathology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
概括
粘膜区域的非典型淋巴细胞增生可以模仿淋巴瘤. 这项研究发现了具有基因重组的非新发性B细胞主导性淋巴细胞增殖 (NBPLP),强调全面评估以防止淋巴瘤误诊.
科学领域:
- 病理学 病理学 病理学
- 免疫学 免疫学 免疫学
- 在瘤学瘤学.
背景情况:
- 淋巴组织病变通常是良性或淋巴瘤.
- 准确的分类是具有挑战性的,特别是在暴露于环境的粘膜区域.
- 环境暴露可能导致非典型的淋巴细胞增生,模仿淋巴瘤.
研究的目的:
- 研究非新发性B细胞主导性淋巴细胞增殖 (NBPLP) 的形态学,免疫类型和分子变化.
- 为了区分NBPLP与环境暴露的粘膜部位的淋巴瘤.
- 为非典型淋巴细胞增生症 (AtLP) 提供诊断见解.
主要方法:
- 从粘膜活检样本 (肠道,尿道,子宫,桃体,舌头) 中检测出18例AtLP.
- 将形态分类为4个亚型 (A,B,C,D).
- 进行了基因重组分析 (BCR和TCR) 和免疫型.
主要成果:
- 在AtLP.观察到不同程度的B细胞激增与形态异型在AtLP.
- 在6/15个案例中发现了积极的BCR基因重组,在1/4个案例中发现了TCR基因重组.
- 随访 (14.2-70个月) 没有发现淋巴瘤的迹象;所有病例都被诊断为NBPLP.
结论:
- 由于抗原暴露,环境暴露的粘膜区域经常存在NBPLP的AtLP.
- 在NBPLP中可以发生积极的IGH重组.
- 为了避免淋巴瘤过度诊断,全面评估 (宏观,形态,免疫类型,分子) 是至关重要的.
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