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背景与目的:原发肾脏的黏膜相关组织淋巴瘤十分罕见,目前世界报道不足50例。本文介绍2例肾脏黏膜相关淋巴瘤的形态学特点和免疫表型特征,旨在使临床和病理对这种低度恶性的B细胞肿瘤的特点有所了解。方法:收集病史资料,形态学评价根据HE切片,用免疫组化法检测肿瘤细胞的表型,使用的抗体包括CD20、CD79、CD5、CD10、CD43、CD23、BCL10和Cyc linD1。结果:2例患者均为女性,年龄分别为48岁和55岁,临床上均有慢性肾盂肾炎病史。B超和CT检查发现肾脏肿块,行全肾切除。大体检查可见肿块位于肾髓质,呈境界不清的暗红色;镜检见肾盂至肾实质弥漫淋巴样细胞浸润,以小淋巴细胞、中心细胞样细胞、淋巴浆细胞和浆细胞浸润为主,可见肿瘤细胞浸润肾小管和肾球囊形成淋巴上皮病变和反应性淋巴滤泡,但没有显著滤泡殖入;免疫组化显示增生细胞以B淋巴细胞为主,散在分布反应性T细胞,肿瘤细胞CD20、CD79 a阳性,CD43弱阳性,CD5、CD10、BCL10、CD23和Cyc linD1均为阴性。结论:原发肾脏黏膜相关淋巴瘤临床极为罕见,临床表现和辅助检查与肾细胞癌不易鉴别,但组织学特点符合经典黏膜相关淋巴瘤的所有特征,免疫表型有助于病理诊断。
BACKGROUND & OBJECTIVE: Mucosa-associated tissue lymphoma of primary kidney is very rare, and less than 50 cases have been reported in the world at present. This article describes the morphological features and immunophenotypic features of two cases of renal mucosa-associated lymphoma, aiming to understand the characteristics of this low-grade B-cell tumor clinically and pathologically. Methods: The histological data were collected. Morphological evaluation was based on HE sections. The phenotypes of tumor cells were detected by immunohistochemistry. Antibodies used included CD20, CD79, CD5, CD10, CD43, CD23, BCL10 and CyclinD1. Results: All the 2 patients were female, aged 48 and 55 years old respectively. All patients had a history of chronic pyelonephritis. B ultrasound and CT examination found that kidney mass, line total nephrectomy. Gross examination showed that the mass was located in the medullary, dark red muddy state; microscopic examination of the renal pelvis to the renal diffuse infiltration of lymphoid cells to small lymphocytes, centrocyte-like cells, lymphocytes and plasma cells infiltration of plasma-based, Tumor cells infiltrated the renal tubular and renal balloon to form lymphoepithelial lesions and reactive lymphoid follicles, but no significant follicular infiltration. Immunohistochemistry showed that proliferative cells were mainly B lymphocytes, with scattered reactive T cells and tumors Cell CD20, CD79 a positive, CD43 weak positive, CD5, CD10, BCL10, CD23 and CyclinD1 were negative. CONCLUSION: Primary renal mucosa-associated lymphoma is extremely rare clinical manifestations and auxiliary examination and renal cell carcinoma is not easy to identify, but histological features consistent with all the characteristics of the classic mucosa-associated lymphoma, immune phenotype contribute to the pathological diagnosis.