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目的探讨不一致性淋巴瘤的临床病理学特征。方法结合临床、影像学、HE形态、免疫组化和分子病理学对1例不一致性腋窝弥漫性大B细胞淋巴瘤(DLBCL)和鼻咽、左颈部血管免疫母细胞性T细胞淋巴瘤(AITL)进行临床病理分析,并复习相关文献。结果患者以全身浅表淋巴结肿大为首发症状,腋窝淋巴结活检诊断为DLBCL,未作任何治疗。4年后发现鼻咽部新生物,活检提示T细胞性淋巴瘤,化疗2个疗程;5个月后出现全身浅表淋巴结肿大伴腹腔淋巴结肿大,活检左颈部淋巴结诊断为AITL;结合免疫组化、基因重排和EBER检测确诊为不一致性腋窝弥漫性大B细胞性淋巴瘤和鼻咽、左颈部血管免疫母细胞性T细胞性淋巴瘤。结论不一致性淋巴瘤罕见,早期很难明确诊断,易误诊而影响临床治疗导致预后不佳。
Objective To investigate the clinicopathological features of incongruent lymphoma. Methods One case of inconsistent axillary diffuse large B-cell lymphoma (DLBCL) and nasopharyngeal and left-neck angioimmunoblastic T-cell lymphoma (DLBCL) with clinical, radiological, AITL) for clinical and pathological analysis, and review the relevant literature. Results Patients with superficial lymph nodes of the body as the first symptom, axillary lymph node biopsy diagnosed as DLBCL, without any treatment. 4 years after the discovery of nasopharyngeal neoplasms, biopsy prompted T-cell lymphoma, chemotherapy 2 courses; 5 months after the emergence of systemic superficial lymph nodes and abdominal lymph nodes, biopsy left neck lymph node diagnosis of AITL; combined with immune Histopathology, gene rearrangements, and EBER tests identified as inconsistent axillary diffuse large B-cell lymphoma and nasopharyngeal and left-neck angioimmunoblastic T-cell lymphomas. Conclusion Inconsistent lymphoma is rare, early diagnosis is difficult to clear, easily misdiagnosed and affect the clinical treatment lead to poor prognosis.