肾移植术后淋巴组织增生性疾病2例病理分析

金 汝佳, 姜 黄*
郑州人民医院，河南中医药大学人民医院

摘要


目的：报道肾移植术后淋巴组织增生性疾病（post-transplantation lymphoproliferative disorders，PTLD）侵
及骨髓2例并复习相关文献，旨在提高对PTLD的认识。方法：回顾性分析河南中医药大学第五临床医学院（郑州
人民医院）2例肾移植术后PTLD侵及骨髓患者的临床与病理学特点，采用HE染色、免疫组织化学染色和流式细胞
学检测，观察其组织学特征、免疫组织化学染色及流式细胞学检测结果进行免疫表型分析，同时收集PTLD相关文
献并进行文献复习。结果：患者2例，男性1例，女性1例，年龄48-76岁，平均62岁，主要临床表现为发热、乏
力、白细胞增多等；2例均行骨髓穿刺术。病理检查：骨髓组织均增生较活跃，肿瘤细胞小至中等大小，呈结节型
或弥漫型分布，胞浆较少，染色质粗，核仁不明显。免疫表型：CD79α、CD20、Pax-5均阳性，CD23少量阳性，
CD3、CD5、CD10、CylinD1均阴性。流式细胞学检测提示骨髓中存在异常增生的克隆性B细胞。病理诊断为CD5
（-）CD10（-）的小B细胞淋巴瘤侵犯骨髓。2例患者均获得随访，肾移植术后生存时间为8年-12年，均存活至今。
结论：PTLD是一种罕见的实体器官移植后并发症，具有独特的病理形态和临床特点。

关键词


肾移植；PTLD；临床病理分析

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参考


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