成人肠道淋巴样息肉病临床病理学特征分析

doi:10.3877/cma.j.issn.2095-655X.2016.01.015

中华诊断学电子杂志 ›› 2016, Vol. 04 ›› Issue (01) : 52 -55. doi: 10.3877/cma.j.issn.2095-655X.2016.01.015

所属专题：文献；

临床研究

成人肠道淋巴样息肉病临床病理学特征分析

邵庆华¹, 杨涓¹, 张帆¹, 郑盛¹^,^†(

)

^1. 650011　昆明，云南省第三人民医院胃肠疾病中心

收稿日期:2015-07-11 出版日期:2016-02-26
通信作者: 郑盛
基金资助:
云南省自然科学基金(2012FD095); 云南省教育厅科研基金重点项目(2014Z125)

Clinicopathological characteristics of intestinal lymphoid polyposis in adults

Qinhua Shao¹, Juan Yang¹, Fan Zhang¹, Sheng Zheng¹^,^†()

^1. Department of Digestive Diseases, Yunnan The Third People’s Hospital, Kunming 650011, China

Received:2015-07-11 Published:2016-02-26
Corresponding author: Sheng Zheng
About author:
Corresponding author: Zheng Sheng, Email: zheng_sheng523@163.com

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目的

探讨成人肠道淋巴样息肉病的临床及病理学特征。

方法

应用光镜及免疫组织化学方法观察2例成人肠道淋巴样息肉病的组织学特点及免疫学表型，并复习相关文献。

结果

2例患者中1例为男性，1例为女性，年龄分别为65岁、46岁。2例病例均因其他疾病切除末端回肠及回盲部时，偶然发现末端回肠多发息肉样隆起，直径0.1 cm～0.5 cm。镜下见回肠黏膜淋巴组织显著增生，淋巴滤泡增生并形成息肉样小结节，淋巴滤泡的生发中心明显增大，围绕生发中心的套区境界清楚。免疫组织化学显示大部分呈滤泡样增生的淋巴细胞CD20强阳性表达，不表达Cyclin D1，生发中心细胞不表达Bcl-2。

结论

成人淋巴样息肉病是一种罕见的良性病变，具有独特的临床病理特点，临床上易于同部分恶性肿瘤相混淆，诊断依靠病理组织学及部分辅助方法。

关键词: 淋巴样息肉病, 病理, 肿瘤, 诊断

Objective

To explore the clinicopathological characteristics of intestinal lymphoid polyposis in adults.

Methods

The histopathological features and immunophenotype of two cases of adult intestinal lymphoid polyposis were studied, relevant literatures were reviewed.

Results

A total of 1 male and 1 female were studied, aged 65 and 46, respectively.In all two cases, identification of the polyposis was incidental during the examination of resected of terminal ileum and ileocecal region due to other diseases.Gross findings were multiple polyps in the terminal ileum, measuring 0.1 cm~0.5 cm in diameter.Hyperplasia of mucosa-associated lymphoid tissue was noticed microscopically.The polyps were composed of closely aggregated lymphoid follicles.The follicles contained prominent germinal centers surrounded by a mantle of small lymphocytes.Immunohistochemical staining showed the follicles to be composed of CD20(+ ) and Clyclin D1(-) lymphocytes.Cells in germinal center did not express Bcl-2.

Conclusion

Lymphoid polyposis is a rare benign tumor featuring unique clinicopathological characteristics, and the diagnosis relies on histopathological analysis and some ancillary markers.

Key words: Lymphoid polyposis, Pathology, Tumor, Diagnosis

图1 例1结肠淋巴样息肉病患者结肠低倍镜下表现(HE ×8)。回肠末端的多发息肉由位于黏膜固有层的紧密聚集的淋巴滤泡组成，淋巴滤泡表现为由小细胞构成的套区围绕显著的生发中心(箭头所示)

图2 例1结肠淋巴样息肉病患者结肠淋巴滤泡低倍镜下表现(HE ×40)。淋巴滤泡生发中心反应性扩大，围以正常的套区，未见明确弥漫性改变及异型细胞(箭头所示)

图3 例2结肠淋巴样息肉病患者淋巴滤泡免疫组化镜下表现(HE ×40)。注：a图示生发中心细胞不表达Bcl-2；b图示淋巴细胞不表达Cyclin D1

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