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目的：本文对１例罕见的纵隔大Ｂ细胞淋巴瘤进行临床病理、免疫组化、病理形态及ＤＮＡ定量测定的研究。方法：采用常规ＨＥ染色及ＡＢＣ免疫组化染色，光镜观察；用ＨＰＩＡＳ－１０００彩色图像分析系统定量测定肿瘤细胞核的形态，以肿瘤周围残存的正常胸腺淋巴细胞作为对照。另对６μｍ厚Ｆｅｕｌｇｅｎ染色切片用ＩＣＭ１００细胞图像分析系统测定肿瘤细胞核的ＤＮＡ倍体。结果：见肿瘤细胞较大，呈弥漫分布，其间可见宽窄不一，成束或带状的纤维结缔组织穿插分割。免疫组化染色表明为Ｂ细胞性，瘤细胞表达ＬＣＡ及Ｌ２６阳性，ＩｇＡ及Ｋ弱阳性。肿瘤细胞形态定量测定结果显示瘤细胞核的１５项形态学参数与对照组间均有高度显著性差异（Ｐ＜０００１），经细胞影像仪测定瘤细胞ＤＮＡ呈高异倍体，ＤＮＡ质量分布呈高度异质性。结论：形态定量测定的方法对于恶性淋巴瘤的诊断能够提供客观的、准确的和定量的依据，并能帮助我们统一诊断标准，克服病理医师在诊断中的主观性和仅根据经验诊断而带来的误差，具有重要的意义。肿瘤细胞ＤＮＡ倍体测定结果对于患者预后判断具有重要的意义。
OBJECTIVE: To investigate the clinical pathology, immunohistochemistry, histopathology, and DNA quantification of a rare mediastinal large B-cell lymphoma. METHODS: Conventional HE staining, ABC immunohistochemical staining, and light microscopy were performed. The HPIAS-1000 color image analysis system was used to quantitatively determine the morphology of tumor cell nuclei. The normal thymic lymphocytes remaining around the tumor served as controls. In addition, 6μm thick Feulgen stained sections were used to measure the DNA ploidy of the tumor cell nuclei using the ICM-100 cell image analysis system. RESULTS: The tumor cells were seen to be dense and diffusely distributed, with varying widths and septa, and bundles or ribbons of fibrous connective tissue were interspersed. Immunohistochemical staining showed B-cells. The tumor cells expressed LCA and L26 positive, while IgA and K were weakly positive. The results of quantitative measurement of tumor cell morphology showed that there were highly significant differences between the 15 morphological parameters of the tumor nucleus and the control group (P<0001). The DNA of the tumor cells was highly heteroploid and the DNA mass distribution was determined by the cell imaging instrument. Highly heterogeneous. Conclusion: Quantitative quantitative methods can provide objective, accurate and quantitative basis for the diagnosis of malignant lymphoma, and can help us to unify the diagnostic criteria, overcome the subjectivity of pathologists in diagnosis, and bring the diagnosis based on experience alone. The error has important significance. The results of DNA ploidy measurement of tumor cells have important significance for the prognosis of patients.