| 摘要: |
| 目的 探讨眼结膜黏膜相关淋巴组织边缘区淋巴瘤临床病理特征、诊断、治疗及预后。方法 回顾性分析了11例原发性眼结膜黏膜相关淋巴组织边缘区淋巴瘤患者的临床、病理资料并进行了随访。结果 患者男性4例，女性7例，发病年龄23岁-74岁，平均年龄45岁。累及部位：累及单侧结膜10例，累及双侧结膜1例，其它部位及系统未见淋巴瘤。病理形态：结膜固有层内弥漫性小-中等大小的淋巴样细胞及单核样细胞浸润，核形轻度不规则。免疫表型：弥漫性浸润细胞CD20(+)、部分病例CD43(+)；CD3(-)、CD5(-)、CD23(-)、CyclinD(-)、ki67增殖指数约1-10%不等。Ig基因克隆性分析：5例行Ig基因克隆性分析，均呈单克隆。治疗：6例单纯肿物完整切除，2例肿物完整切除加局部放疗，1例肿物部分切除加局部放疗，1例单纯活检，1例活检后局部注射化疗，肿物未消退，随后行肿物完整切除加局部放疗；随访：随访时间3~122个月，截止随访日期，除2例失访，所有患者均生存，其中行肿物单纯活检的病例长期带瘤生存，余8例均未见复发。结论 眼结膜黏膜相关淋巴组织边缘区淋巴瘤好发于中年女性，结膜见粉红色肿物为临床特征，镜下为小-中等大小的淋巴样细胞及单核样细胞弥漫性浸润，肿瘤细胞表达B淋巴细胞表型，增殖指数低，部分病例异常表达CD43，Ig基因克隆性分析有助于诊断，单纯肿物完整切除或术后辅以局部放疗均有较好的疗效，预后良好。 |
| 关键词: 黏膜相关淋巴组织边缘区淋巴瘤 淋巴瘤 结膜 |
| DOI： |
| 分类号: |
| 基金项目: |
|
| Clinical and pathological features of conjunctiva mucosa associated lymphoid tissue marginal zone lymphoma |
|
wen zong hua1,2,3
|
|
1.The People'2.'3.s Hospital of Guangxi Zhuang Autonomous Region
|
| Abstract: |
| Purpose To explore the clinical and pathological features of conjunctiva mucosa associated lymphoid tissue marginal zone lymphoma ( EMZL).Methods Clinical data of 11 cases of conjunctiva EMZL patients were retrospectively analyzed and follow-up.Results In the 11 cases,4 were male,7 females,with age ranging from 23 to 74 years(mean45years).Location:10 were unilateral,1 was bilateral, no lymphoma was found in other sites or systems. The pathological morphology showed a large number of dense small to medium sized lymphoid cells and monocytoid B cells were diffusely infiltrated in the mucosal lamina propria,those nuclear show mild irregularity.The immunophenotyping showed that infiltrating cells expressed CD20,and did not express CD3,CD5,CD23,CD10,CyclinD1,with a low proliferation index of ki-67 and aberrant expression of CD43 in some cases.Ig gene clonal analysis:5 cases were monoclonal.The follow-up time was 3 months up to 122 months and the results showed that all patients were survival, except 2 were navailable for follow-up. Long-term survival with tumor was observed in the patients receiving simple biopsy of tumor, and no recurrence was observed in the remaining 8 patients.Conclusion Conjunctiva EMZL is mainly found in the middle-aged,with a female predominance.Typical conjunctival EMZL presents as a fleshy, often mobile,nonlobulated salmon-pink patch.Microscopically,it is mainly composed of small marginal zone B cells were diffusely infiltrated in the mucosal lamina propria,with immunophenotype of B cell and a low proliferation index of ki-67,with aberrant expression of CD43 in some cases.Ig gene clonal analysis contribute to diagnosis. Simple complete resection of the tumor or postoperative adjuvant local radiotherapy showed good efficacy and good prognosis.inert clinical processes and good prognosis． |
| Key words: EMZL Lymphoma Conjunctiva |
