MANTLE ĆELIJSKI LIMFOM – UBICA DEČIJEG LICA
Sažetak
Mantle ćelijski limfom (MCL) je poseban tip non-Hodgkinovog limfoma sa veoma agresivnim kliničkim ponašanjem. Uprkos svojoj blagoj, uniformnoj morfologiji, MCL je neizlečiva i smrtonosna bolest, iako je prepoznato nekoliko varijanti sa indolentnijim kliničkim tokom. Cilj ove studije je sveobuhvatna analiza patomorfoloških karakteristika MCL kod pacijenata iz jugoistočne Srbije i određivanje učestalosti u našoj populaciji. Tokom petogodišnjeg perioda dijagnoza MCL je postavljena u 47 slučajeva, što čini 10,3% svih novodijagnostikovanih limfoma u Centru za patologiju Univerzitetskog kliničkog centra Niš. Većina obolelih su bili muškarci, 72,3%, a prosečna starost pacijenata u trenutku postavljanja dijagnoze bila je 66,1 godina. Ekstranodalna prezentacija je bila prisutna u 61,7%. Svaki četvrti slučaj MCL dijagnostikovan je biopsijom koštane srži. Usna duplja i gastrointestinalni trakt podjednako su zastupljeni kao ekstranodalna dijagnostička lokacija, sa po 17%. MCL obuhvata širok spektar histoarhitektonskih obrazaca i citoloških varijanti, te dijagnostika zahteva imunohistohemijsku analizu ekspresije CyclinD1 i SOX11 za tačnu dijagnozu i diferencijaciju od drugih limfoidnih neoplazmi i reaktivnih i hiperplastičnih stanja. Morfološke varijante MCL-a mogu se lako pomešati sa potencijalno izlečivim ili indolentnim limfomima. Tačna i precizna dijagnoza MCL može poboljšati ishod bolesti blagovremenom primenom novih i obećavajućih strategija lečenja. Uloga patologa u pravilnom prepoznavanju i brzoj dijagnozi MCL i određivanja njegovog podtipa, posebno u biopsijama sa ekstranodalnih lokacija, uključujući endoskopske biopsije, može značajno doprineti dužem preživljavanju obolelih i boljem kliničkom ishodu bolesti.
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