临床与实验病理学杂志Issue(5)：518-522,5.DOI:10.13315/j.cnki.cjcep.2015.05.009
原发性乳腺弥漫性大B细胞淋巴瘤7例临床病理及预后分析
Primary breast diffuse large B-cell lymphoma:a clinicopathologic study and prognosis analy-sis of seven cases
摘要
Abstract
Purpose To discuss the clinical pathological features, diagnosis and differential diagnosis, treatment and prognosis of pri-mary breast diffuse large B-cell lymphoma ( DLBCL) . Methods 7 cases of primary breast DLBCL were collected, their clinical path-ological characteristics and immunophenotypes were also observed, and the treatment and prognostic factors were discussed. Results All of the 7 patients were women, aged 28~75 years, with the median 51 years. 5 cases involved left breast, 2 cases were located in the right breast. Painless mammary mass and ipsilateral axillary lymphadenopathy were the commonest clinical manifestations. On mi-croscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mamma-ry gland, around the duct, interstitial and fat tissue, some were single file cord pattern. 1 case was ALK-1 positive DLBCL, 6 cases were DLBCL of the non special type. The immunophenotype showed 5 cases were of non-GCB, 2 cases were of GCB type. Ki-67 index were from 60% to 95%. According to Ann Arbor staging, 2 cases were stage I EA, 5 cases were stage II EA. IPI score:4 cases with 0 score, 3 cases with 1 score. Of 7 patients, one case was modified radical mastectomy, 4 cases were lumpectomy, 2 cases were diag-nosed by core needle biopsy. 2 patients died without chemotherapy, 5 patients were chemotherapy or radiotherapy for 4 to 6 cycles ( CHOP/R-CHOP) , 4 patients received complete response, one died. Patients were followed up from 1 to 114 months, the median fol-low-up time was 18 months. The 1 year OS rate was 57. 1%, 5 years OS rate was 14. 3%. Conclusion The diagnosis of primary breast DLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively eval-uated by multiple factors.关键词
乳腺肿瘤/弥漫性大B细胞淋巴瘤/免疫表型分型/预后Key words
breast neoplasm/diffuse large B-cell lymphoma/immunophenotype/prognosis分类
医药卫生引用本文复制引用
刘银华,王素芬,徐洪海,李佳嘉,徐国祥,卢林明..原发性乳腺弥漫性大B细胞淋巴瘤7例临床病理及预后分析[J].临床与实验病理学杂志,2015,(5):518-522,5.基金项目
安徽省高校省级自然科学研究(KJ2013Z336) （KJ2013Z336）
