原发性乳腺恶性淋巴瘤36例临床病理分析

摘要

目的 探讨原发性乳腺淋巴瘤(primary lymphoma of breast,PBL)的临床病理特点、免疫表型及鉴别诊断.方法 回顾性分析36例PBL的临床病理资料和免疫表型,结合文献对其临床病理特点进行分析.结果 36例PBL均为女性,年龄28～74岁,中位数49岁,≥49岁者19例,占52.7%,肿块位于右侧乳腺者19例(占52.7%),位于左侧乳腺者15例(占41.7%),双侧乳腺2例(占5.6%);弥漫大B细胞淋巴瘤(diffused large B cell lymphoma,DLBCL)22例,占61.1%;黏膜相关淋巴组织(mucosa associated lymphoid tissue,MALT)淋巴瘤7例,占19.4%;滤泡性淋巴瘤(follicular lymphoma,FL)2例,占5.6%;T淋巴母细胞性淋巴瘤(T lymphoblastic lymphoma,T-LBL)2例,占5.6%;外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTCL)3例,占8.3%.结论 PBL少见,多发生于中老年女性;PBL大多是B细胞淋巴瘤,DLBCL最常见,其次是MALT淋巴瘤.PBL确诊依赖组织病理学,免疫组化标记对明确诊断、分型和鉴别诊断具有一定的价值.%Purpose To investigate the clinicopathological features, immunophenotypes and differential diagnosis of primary lymphoma of breast( PBL ). Methods Histopathological characteristics and immunohistochemical results of 36 cases of PBL were retrospectively studied and the relevant literatures were reviewed. Results All 36 patients were female, which aged from 28 to 74 with a median of 49 years including 19 cases were over 49 years old ( 52. 7% ). The right and the left breasts were involved in 19 ( 52. 7% ) and 15 patients ( 41. 7% ), respectively. 2 patients ( 5. 6% ) presented with bilateral involvement. 22 cases were diffused large B cell lymphoma ( DLBCL ) ( 61. 1% ), 7 cases were mucosa associated lymphoid tissue ( MALT ) lymphoma ( 19. 4% ), 2 cases were follicular lymphoma ( FL ) ( 5. 6% ), 2 cases were T lymphoblastic lymphoma ( T-LBL ) ( 5. 6% ), 3 cases were peripheral T-cell lymphoma ( PTCL ) ( 8. 3% ). Conclusions Primary lymphoma of breast is rare and mostly occurs in middle and elderly female. The majority of them are B cell lymphoma, of which the most common type is DLBCL, followed by MALT lymphoma. The diagnosis of lymphoma rely on the histopathology. Immunohistochemical marker is definite value for diagnosis, classification and differential diagnosis.