标题：原发性乳腺淋巴瘤六例临床病理分析

      作者：陈芳 1，杨文婷 1，钟桂棉 2    广州市番禺区中心医院病理科 1、影像科 2，广东 广州 511400

      卷次： 2021年32卷22期

      【摘要】 目的 探讨原发性乳腺淋巴瘤(PBL)的临床病理特征、鉴别诊断及预后。方法 回顾分析广州市番禺区中心医院2009年1月1日至2020年12月30日收治的6例PBL患者的临床病理特点、免疫表型及随访信息，并复习相关文献。结果 6例均为女性，发病年龄34~84岁，平均55.8岁；左乳4例，右乳2例，均为单侧乳腺肿块无痛性进行性增大，或伴同侧淋巴结肿大。镜下均见异型淋巴细胞浸润乳腺组织生长，表达B细胞标记，其中乳腺原发弥漫性大 B细胞淋巴瘤(PB-DLBCL) 5例，2例非GCB型，3例GCB型；1例为黏膜相关淋巴组织结外边缘区(MALT )淋巴瘤。6例患者均未见骨髓累及，均不伴B症状。治疗以手术联合CHOP/R-CHOP方案化疗 6个疗程伴放疗为主。截止 2020年 12月，6例患者在随访 9~86个月后均未复发，病例 3因上消化道出血死亡，其余存活。 结论 PBL罕见，大多数发生于女性，表现为单侧乳腺包块无痛性进行性增大，临床易误诊，其诊断和鉴别主要依靠病理组织学和免疫组化、分子病理。组织学类型大多数是PB-DLBCL，少数是MALT淋巴瘤。治疗以术后CHOP/R-CHOP足疗程化疗联合放疗等综合治疗为主，及时充分治疗预后好。
      【关键词】 原发性乳腺淋巴瘤；乳腺原发弥漫性大B细胞淋巴瘤；临床病理特征；影像学；治疗；预后
      【中图分类号】 R737.9 【文献标识码】 A 【文章编号】 1003—6350（2021）22—2899—05

Clinicopathological analysis of primary breast lymphoma: a report of 6 cases.
CHEN Fang 1, YANG Wen-ting 1,ZHONG Gui-mian 2. Department of Pathology 1, Department of Imaging 2, Guangzhou Panyu Central Hospital, Guangzhou511400, Guangdong, CHINA
【Abstract】 Objective To explore the clinicopathological features, diagnosis, differential diagnosis and progno-sis of primary breast lymphoma (PBL). Methods The clinicopathological characteristics, immunophenotypes and fol-low-up information of 6 patients with PBL admitted to Department of Pathology, Guangzhou Panyu Central Hospitalfrom January 1, 2009 to December 30, 2020 were retrospectively analyzed by HE staining and immunohistochemicalmethod, and the related literatures was reviewed. Results All 6 patients were women with age of 34-84 years old, witha mean age of 55.8. There were 4 cases of left breast and 2 case of right breast, which all showed the painless mass of theunilateral breast increasing progressively, with or without ipsilateral axillary lymphadenopathy. Microscopically, PBLsfrequently appeared as a mass composed of a proliferation of lymphoid cells with frequent infiltration of normal breastepithelium with lymphoepithelial lesions, expressing B-cell markers. There were 5 primary breast diffuse large B-celllymphoma (PB-DLBCL) and 1 mucosa-associated lymphoid tissue (MALT) lymphoma. Bone marrow involvementwas not observed and there were no B symptoms present in all 6 patients. The treatment was usually 6 courses of che-motherapy of CHOP/R-CHOP in time, combined with radiotherapy after biopsy. During the follow-up until December2020, all 6 cases had survived for 9-86 months without recurrence, case 3 had died for upper gastrointestinal bleed-ing, and the rest were all alive.Conclusion PBL is a rare, and mainly occurs in females. It usually shows the painlessmass of the unilateral breast increasing progressively. As its clinical manifestations is similar with breast cancer, it iseasily missed or misdiagnosed. Its diagnosis and differentiation mainly rely on pathological histology and immunohis-tochemistry, molecular pathology. PBLs are mainly B-cell lymphomas, and the most common type is PB-DLBCL, fol-lowed by MALT. Adequate hemotherapy of CHOP/R-CHOP in time combined with radiotherapy can result in goodprognosis.
      【Key words】 Primary breast lymphoma (PBL); Primary breast diffuse large B-cell lymphoma (PB-DLBCL); Clini-copathological features; Imaging features; Treatment; Prognosis