2022 年第 9 期 第 17 卷

超声引导下穿刺活检对滤泡性淋巴瘤诊断局限性的病理学及生物学机制探究

Investigating pathological and biological mechanism of follicular lymphoma by ultrasound-guided biopsy

作者：孙阳张勇跃王淑敏

英文作者：Sun Yang Zhang Yongyue Wang Shumin

单位：北京大学第三医院超声科，北京100191

英文单位：Department of Ultrasonography Peking University Third Hospital Beijing 100191 China

关键词：滤泡性淋巴瘤；超声引导下穿刺活检；诊断；局限性

英文关键词：Follicularlymphoma;Ultrasound-guidedbiopsy;Diagnosis;Limitations

• 摘要：

• 滤泡性淋巴瘤是一种具有高度肿瘤异质性的疾病，在诊断过程中，超声引导下穿刺活检常因取材不足易出现假阴性的结果，常需多次穿刺活检以明确病理诊断及分型。本文从病理学及生物学发展等角度对超声引导下穿刺活检对滤泡性淋巴瘤取材不足、进而造成诊断局限性的原因进行分析。病理学方面，异常增生的B细胞中，同时存在中心细胞及中心母细胞，二者以不同比例混合，在排列上常呈散乱分布。滤泡性淋巴瘤的组织学模式为滤泡样结构，与反应性增生的淋巴结相似；在生物学发展进程中，病变部位同时存在低级别与高级别的肿瘤细胞，并与非恶性淋巴细胞共同构成肿瘤微环境。

• Follicular lymphoma is a disease with high tumor heterogeneity. In the process of diagnosis, ultrasound-guided biopsy is often prone to false negative results due to insufficient tissue materials. Multiple biopsies are often required to clarify the pathological diagnosis and classification. From the perspective of pathology and biological development, this paper analyzes the causes of insufficient tissue materials of follicular lymphoma by ultrasound-guided biopsy, which leads to the limitation of diagnosis. Pathologically, there are both central cells and central mother cells in dysplastic B cells, which are mixed in different proportions and often scattered in arrangement. The histological pattern of follicular lymphoma is follicular like structure, which is similar to reactive proliferative lymph nodes. In the process of biological development, there are both low-level and high-level tumor cells in the lesion, and together with non malignant lymphocytes constitute the tumor microenvironment.