结外鼻型NK/T细胞淋巴瘤的临床病理研究

摘要

Objective To discuss the clinicopathologic and Immunohistochemical characteristics of extranodal nasal-type natural killer/T cell lymphoma(ENT-NK/TCL). Methods A retrospective study was carried out among 43 cases with ENT-NK/TCL, to sum up the clinicopathologic and immunohistochemistic characteristics of this condition. Results The early clinical manifestation of ENT-NK/TCL is not specific,which is easy to be misdiagnosed and mistreated;The lesion are situated in inferior concha or nasal septum,which show mucosal erosion,ulcer or nodosus exogenous goiter;Histopathology reveal tumor cell which surround and encroach blood vessel are pleomorphic,immunohistochemical staining express related antigen phenotype of NK or T cell; CT/MRI scanning may be helpful for evaluating the involved range of lesion and decision making in its clinical phase;Main treatment are synthetic radiotherapy and chemotherapy. Conclusion The clinical manifestation of ENT-NK/TCL is not typical,but this lesion show unique histopathologic and Immunohistochemical characteristics.There is some trouble making a more definite diagnosis simply based on its clinical manifestations, mainly on the basis of pathohistology made once or more times on tissue samples from a biopsy in multiple locations and on the basis of immunohistochemistry to provide powerful evidences, can a final diagnosis be made for ENT-NK/TCL.%目的：探讨结外鼻型NK/T细胞淋巴瘤（Extranodal nasal-type natural killer/T cell lymphoma, ENT-NK/TCL）的临床病理、免疫组化特征。方法回顾分析43例ENT-NK/TCL的临床病理资料，总结其临床病理及免疫组化特点。结果 ENT-NK/TCL早期临床表现不典型，易误诊误治；病变主要位于下鼻甲、鼻中隔，表现为鼻黏膜糜烂、溃疡或结节状外生性肿物；组织病理示瘤细胞呈多形性，具有血管中心性和亲血管性；免疫组化染色表达NK细胞及T细胞相关抗原表型；CT/MRI利于确定病变范围及临床分期；治疗主要采用放疗和化疗相结合。结论 ENT-NK/TCL临床表现缺乏特异性，但具有独特的病理、免疫学特点，多点、多次病理活检及免疫组化检查是确诊ENT-NK/TCL的主要依据。