摘要
目的:探讨硬腭部位被误诊为慢性口腔溃疡病变的非霍奇金(NHL)弥漫性大B细胞淋巴瘤(DLBCL)的临床病理特征、诊断及鉴别诊断。方法:回顾性分析1例发生在硬腭以溃疡为临床表现并诊断为DLBCL患者的临床、病理资料,行HE染色,免疫组化SP法检测病变及周围组织形态及其中相关蛋白和基因表达。从TCGA数据库下载46例DLBCL患者的转录本、临床数据及生存数据,用Logrank检验Kaplan Meier(KM)生存分析比较高低表达两组之间的生存差异。结果:硬腭病损临床表现似溃疡,无特异性,病变及周围组织中Bcl2、Bcl6、CD20、CD45、PAX5、MUM1阳性,vimentin部分阳性,CD3少量阳性;Ki-67阳性率约为80%;CD10、CD21、CD30、CyclinD1、S-100、CKpan阴性。EBER原位杂交阴性。细胞形态特征及免疫组化表型符合DLBCL。MUM1表达与无病生存期(DFS)有明显关联(P=0.033),高表达组的DFS更短。结论:首发在硬腭的结外型DLBCL临床可以以慢性口腔溃疡为表征,易误诊,结合病理学、免疫组化及原位杂交检测可提高本病诊断的准确性。
Objective:To study the clinicopathological features and diagnosis of non Hodgkin's diffuse large B-cell lymphoma(DLBCL).Methods:A retrospective analysis was performed to study the clinical and pathological data of a patient with DLBCL which presented as an ulcer occurred in hard palate,in which HE staining,immunohistochemistry and in situ hybridization were performed for detection of DLBCL related protein and gene expression.The prognosis was analyzed by Kaplan Meier(KM)of Logrank based on TCGA.Results:The examinations showed that in the lesion tissue Bcl2,Bcl6,CD45,PAX5 and MUM1 were positive,vimentin and CD3 were partly positive,Ki-67 was 80%positive,CD10,CD21,CD30,Cyclin D1,S-100 and CKpan were negative.Survival analysis of TCGA data base indicated that MUM1 were related to disease free survival(DFS)of DCBCL patients.Conclusion:DLBCL appeared in the hard palate may be clinically characterized by chronic oral ulcer,pathological examination,immunohistochemistry and in situ hybridization can improve the diagnostic accuracy of the disease.MUM1 is ralated to the DFS of the patients.
作者
张梦莲
聂敏海
刘耀强
李丹
胡馨月
刘旭倩
ZHANG Menglian;NIE Minhai;LIU Yaoqiang;LI Dan;HU Xinyue;LIU Xuqian(Department of Periodontics&Oral Mucosal Diseases,The Affiliated Stomatology Hospital of Southwest Medical University,China,Luzhou646000;Oral and Maxillofacial Surgery,The Second Affiliated Hospital of Hebei Medical University,Shijiazhuang;Department of Pathology,The Second Affiliated Hospital of Hebei Medical University,Shijiazhuang)
出处
《实用口腔医学杂志》
CAS
CSCD
北大核心
2022年第4期500-504,共5页
Journal of Practical Stomatology
基金
四川省科技厅科技计划项目(编号:2020YJ0387,2022NSF-SC0716)
西南医科大学校级应用基础重点项目(编号:2021ZKZD010)
中央引导地方科技发展项目(编号:2021ZYD0083)。
关键词
口腔溃疡
误诊
病理
弥漫性大B-细胞淋巴瘤
硬腭
Oral ulcer
Diagnostic errors
Pathology
Lymphoma large B-cell diffuse
Hard palate
