论文部分内容阅读
目的探讨骨原发性霍奇金淋巴瘤(POHL)的临床病理特征、鉴别诊断及治疗。方法收集1例胸骨POHL的临床资料,观察其组织学特点及免疫组化表达,复习相关文献。结果患者男性,19岁。持续性胸前区肿痛1个月。CT示胸骨溶骨性病灶。病灶活检组织见较多量单核及多核R-S细胞,散在或簇状分布于混合性炎症背景中。免疫组化显示R-S细胞CD30、CD15和PAX5均(+),LCA、ALK、CD3、CD20、CD1a和EMA等均(-)。治疗采用ABVD方案化疗,2个疗程后病灶明显缩小,症状消失。结论霍奇金淋巴瘤多见于淋巴结内,POHL罕见,极易误诊并延误治疗,确诊需综合临床、影像、病理组织学及免疫组化,有较好的治疗效果及预后。
Objective To investigate the clinicopathologic features, differential diagnosis and treatment of bone primary Hodgkin’s lymphoma (POHL). Methods One case of sternal POHL was collected and the histological features and immunohistochemical expression were observed. The related literatures were reviewed. Results The patient was male, 19 years old. Persistent chest area swelling and pain for 1 month. CT showed sternal osteolytic lesions. Lesions biopsy see a larger amount of mononuclear and multinucleated R-S cells scattered or clustered in the mixed inflammatory background. Immunohistochemistry showed that both CD30, CD15 and PAX5 (+), LCA, ALK, CD3, CD20, CD1a and EMA in R-S cells were all (-). Treatment with ABVD chemotherapy, 2 lesions significantly reduced, the symptoms disappear. Conclusions Hodgkin ’s lymphoma is more common in the lymph nodes. POHL is rare and easily misdiagnosed and delayed treatment. It needs comprehensive clinical, imaging, histopathology and immunohistochemistry to diagnose and treat Hodgkin’ s lymphoma. It has better curative effect and prognosis.