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56岁男性,颈部多发肿物。

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楼主 发表于 2012-10-31 10:46|举报|关注(1)
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56岁男性,颈部多发肿物。图1
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56岁男性,颈部多发肿物。图2
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56岁男性,颈部多发肿物。图3
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56岁男性,颈部多发肿物。图4
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56岁男性,颈部多发肿物。图7
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病理,让疾病明明白白。
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arhus 离线

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1 楼    发表于2012-10-31 17:06:04举报|引用
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主要病变在滤泡间区,做四项基本标记(CD3/CD20/CD21/KI-67)后,如果滤泡间区是CD3细胞弥漫阳性,就补充CD2、CD5、CD7;如果是CD20弥漫阳性,就补充CD5、CD43。如果T细胞抗原有丢失就是T细胞淋巴瘤;如果B细胞有异常表达就是B细胞淋巴瘤;如果都没有就暂时诊断淋巴组织不典型增生,建议观察随访,必要时再取活检。

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panzenggang 离线

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2 楼    发表于2012-11-02 10:51:44举报|引用
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Beautiful slides.

The architecture of lymph node is partially affaced with marked interfollicular expansion and focal residual lymphoid follicles. The interfollicular areas consists of a mixed population of small lymphocytes, largers transformed lymphocytes, histiocytes/largerhans cells, eosinophils and high-endothelial venules. Overall, there is obvious morphologic evidence of lymphoma, but I totally agree with Dr. Arthus; basic immunostainis are necessary to rule out a T- or B-cell lymphoma. Other differential diagnosis also includes:

1). Infectious process. EBV, CMV or other virus.

2). Medication or vaccination.

3). Please do CD30 to rule out Hodgkin lymphoma or other sneakLy ALCL/PTCL.

4). Look carefully for myeloid sarcoma, which I think it is very unlikely in the case.

5). If all obove are ruled out, maybe consider doing IgG and IgG4 to rule out "IgG4 associated lymphadenopathy, paracortical expansion variant".

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panzenggang 离线

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3 楼    发表于2012-11-02 10:51:54举报|引用
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Beautiful slides.

The architecture of lymph node is partially affaced with marked interfollicular expansion and focal residual lymphoid follicles. The interfollicular areas consists of a mixed population of small lymphocytes, largers transformed lymphocytes, histiocytes/largerhans cells, eosinophils and high-endothelial venules. Overall, there is obvious morphologic evidence of lymphoma, but I totally agree with Dr. Arthus; basic immunostainis are necessary to rule out a T- or B-cell lymphoma. Other differential diagnosis also includes:

1). Infectious process. EBV, CMV or other virus.

2). Medication or vaccination.

3). Please do CD30 to rule out Hodgkin lymphoma or other sneakLy ALCL/PTCL.

4). Look carefully for myeloid sarcoma, which I think it is very unlikely in the case.

5). If all obove are ruled out, maybe consider doing IgG and IgG4 to rule out "IgG4 associated lymphadenopathy, paracortical expansion variant".

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4 楼    发表于2012-11-02 13:33:41举报|引用
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滤泡间区膨胀性生长,结构还是破坏的,倾向淋巴瘤。

背景细胞较杂,血管增生,T可能性较大。

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蓝宝石6628 离线

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5 楼    发表于2012-11-03 16:51:44举报|引用
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淋巴瘤?

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