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目的通过观察原发性乳腺弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床资料、病理学特征和免疫组化检测结果,探讨其诊断、鉴别诊断和治疗方法。方法通过分析彩超、HE形态学改变和免疫组化结果,对右江民族医学院附属医院(以下简称我院)收治的1例原发性乳腺DLBCL进行确诊,并温习相关文献进行讨论。结果彩超示左乳探及一大小40mm×35mm×25mm低回声团块,边界尚清。光镜下见乳腺组织被弥漫浸润的异型淋巴样细胞所取代,肿瘤细胞大部分区域排列成单列。免疫组化标记物:CD20、CD79a、Mum-1、Bcl-2、CD45、Ki67均阳性表达,ER、PR、HerbB-2、E-cadherin均阴性表达。综合彩超、组织形态学及免疫组化结果证实为原发性乳腺DLBCL。结论原发性乳腺DLBCL相对少见,与乳腺癌难以辨别,诊断主要依靠组织形态学与免疫组化进行确诊,治疗主要以全身化疗及局部放疗为主。
Objective To observe the clinical data, pathological features and immunohistochemical results of primary breast diffuse large B cell lymphoma (DLBCL) and discuss its diagnosis, differential diagnosis and treatment. Methods One case of primary breast DLBCL admitted to Affiliated Hospital of Youjiang Medical College for Nationalities (hereinafter referred to as our hospital) was diagnosed by analyzing the results of color Doppler ultrasonography, HE morphological changes and immunohistochemistry, and the related literatures were reviewed. Results Ultrasonography showed left breast exploration and a size of 40mm × 35mm × 25mm hypoechoic mass, the boundary is clear. Light microscope, see the breast tissue was diffuse infiltration of atypical lymphoid cells replaced most of the tumor cells arranged in a single column. Immunohistochemical markers: CD20, CD79a, Mum-1, Bcl-2, CD45, Ki67 were positive expression of ER, PR, HerbB-2, E-cadherin were negative expression. Comprehensive color Doppler ultrasound, histomorphology and immunohistochemistry results confirmed that the primary breast DLBCL. Conclusion DLBCL is relatively rare in primary breast cancer and is indistinguishable from breast cancer. The diagnosis mainly depends on histomorphology and immunohistochemistry. The main treatment is systemic chemotherapy and local radiotherapy.