目的:对中国首例肾移植后同时伴有胸水及腹水的原发性渗出性淋巴瘤(primaryeffusionlymphoma,PEL)患者的临床资料及组织学特点进行分析。方法:采用细胞形态学、免疫组化以及分子病理学方法对PEI,患者进行诊断,并结合文献进行讨论。结果:PEL细胞形态学特点为细胞呈散在分布,胞体大,胞核深染,核浆比增大,核分裂相易见,可见瘤细胞的多形性;免疫组化检测结果显示,PEI.细胞中人疱疹病毒8型(humanherpesvirus8,HHV8)、CD30、CD45、波形蛋白(vimentin)、上皮膜抗原(epithelialmembraneantigen,EMA)等抗原呈阳性表达,而T细胞或B细胞抗原呈阴性;分子病理学检查发现,PEL细胞有单克隆性IgH基因及IgK基因重排。结论:了解PEL的病理及临床特点对其鉴别、诊断及治疗有重要意义。
Objective:To analyze the clinical datum and histologic features of the first case of recipient with primary effusion lymphoma (PEL) with both pleural fluid and ascites after renal transplantation in China. Methods:PEL patients were diagnosed by cytomorphology, immunocytochemistry and molecular pathology, and the related literatures were reviewed. Results: Cyto- morphology characteristics of PEL cells were large and scattered, with nuclear cytoplasmic ratio increased, and the mitotic rate was high. Immunohistochemisty results showed positive expression of antigens of human herpesvinus 8 (HHVS), CD30, CD45, vimentin and epithelial membrane antigen(EMA) in PEL cells, whereas no immunophenotypic evidences of B- or T-cell antigens were found. Molecular pathological analysis showed a rearrangement of monoclonal gene IgH and lgK in PEL cells. Conclusions: Understanding the pathological and clinical characteristics of lymphoma enables a confident identification, diagno- sis and treatment for PEL.