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1、DISEASES OF LYMPHOID AND HEMATOPOIETIC TISSUES / SYSTEM 淋巴造血组织系统疾病 淋巴网状组织：结构和功能,天津医科大学 病理学教研室,ORGANS 器 官 Reactive hyperplasia (benign) Thymus 胸腺 反应性增生(良性) Spleen 脾 Lymph nodes 淋巴结 Neoplastic hyperplasia (malignant：Lymphoma) Tonsils 扁桃体 肿瘤性增生(恶性：淋巴瘤) DISSEMINATED 散在性 Hodgkin lymphoma 霍奇金淋巴瘤(HL) all o
2、ver the body Non-Hodgkin lymphoma 非霍奇金淋巴瘤(NHL) Skin 皮肤 B-cell neoplsms B细胞淋巴瘤 GI 消化道 T/NK-cell neoplsms T/NK细胞淋巴瘤 RS 呼吸系统 Lymphocytic leukemia 淋巴细胞性白血病 US 泌尿系统 Histiocytic & Dendritic cell neoplasms CNS 中枢神经系统 组织细胞和树状突细胞肿瘤 Others usually Lymphadenopathy 淋巴结病(淋巴结肿大) arising from BM,LYMPHOID TISSUE 淋巴
3、组织,周身淋巴组织的分布,Transformation of lymphocytes 淋巴细胞转化,淋巴细胞转化：B细胞,培养中的淋巴细胞， 受植物血凝素作用后： A.0小时 B.1小时 C-F.24小时,淋巴细胞转化,依Lennert(1975),淋巴细胞系：一些细胞类型的光镜形态,Mucosa-associated lymphoid tissues (MALT) 黏膜相关淋巴组织,恶 性 淋 巴 瘤：概 述,黏膜相关淋巴组织,FC,MZ,MAR,黏膜相关淋巴组织,黏膜相关淋巴组织淋巴瘤MALToma,胃MALToma ：淋巴上皮病变,腮腺MALToma ：淋巴上皮病变,乳腺MALToma
4、：淋巴上皮病变,子宫内膜MALToma：淋巴上皮病变,Lymph Nodes 淋 巴 结,1. Fibrous frame 纤维性网架 Capsule 包膜 Trabeculum 小梁 Reticular fibers 网状纤维 2. Lymphoid parenchyma 淋巴组织实质 3. Lymph drainage 淋巴引流路径 4. Blood circulation 血液循环,(1)CORTEX 皮质 Follicles 滤泡B cell zone B细胞区 : Primary F 初级滤泡: Virgin B cells 童真性B细胞 Mature B cells 成熟B细胞 F
5、ollicular dendritic cells 滤泡性树状突细胞(FDC)* (CD21+) Secondary F 次级滤泡: Mantle zone 套层 Mantle cells 套细胞(Small lymphocytes 小淋巴细胞, IgM+D) Germinal center 生发中心 Centroblasts 中心母细胞 Centrocytes 中心细胞(CD10+，IgM, Ig, IgA or IgE, IgD) Follicular dendritic cells 滤泡性树状突细胞(FDC)* (CD21+) T lymphocytes T淋巴细胞(CD10 stron
6、gly +; usually CD4+/helper and CD57+) Histiocytes 组织细胞 Tingible body macrophages 可染小体巨噬细胞(CD68+) Marginal zone 边缘区 Marginal zone cells 边缘区细胞 / Monocytoid B cells 单核细胞样B细胞(IgM) Interfollicular zone滤泡间区 T cell zone T细胞区 T lymphocytes T淋巴细胞(CD4CD8) Interdigitating dendritic cells (2)PARACORTEX 副皮质(Deep
7、 cortex 深皮质) 交指样树状突细胞(IDC)*(S-100+) Transformed B cells 转化性B淋巴细胞 (3)MEDULLA PCV 毛细血管后小静脉 Medullary cords 髓索 B cell zone B细胞区 : Plasmacytoid lymphocytes 淋巴浆细胞样淋巴细胞 (CD20 ,IgM+) Plasma cells 浆细胞(CD38+,CD138+,IgG+,+/+) *FCD,ICD and LC(Langerhans cells): Accessary cells of immunity 免疫辅佐细胞 PCV=Postcappil
8、lary venules (High endothelial venules,HEV 高内皮小静脉 ),Lymphoid parenchyma 淋巴组织实质,Cortex 皮质：Primary Follicles 初级滤泡,The evolution of follicles 淋巴滤泡的演化,Direction of antigen influx,Mantle zone thicker at the top (“corona“),Light zone of germinal center,Dark zone of germinal center (more large cells),Light
9、 zone,Dark zone,Stary sky,Stary sky,Centrocytes,Centroblasts,Tingible body cells,FDC,FDC,CD21(FDC),中心母细胞中心细胞,浆母细胞,CD20(B cdlls),CD45RO(T cells),Organization of secondary lymphoid follicle,Marginal zone cells (IgM),Mantle zone cells (IgM+D),Follicle center cells (IgM, IgG, IgA or IgE, not IgD),Mentle
10、 zone/Mentle cells 淋巴滤泡：套层/套细胞,Marginal zone / Marginal cells (Monocytoid B cells) 淋巴滤泡：边缘区/边缘区细胞 (单核细胞样B细胞),*,*,*,*,Ma,C,M,Ca,S,Ma,C,M,Ca,S,Mantle zoneMantle cells,Mantle zone,Marginal zone,Paracortex,Paracortex,IDC,Paracortex,CD3,CD20,Sinus histiocytes,Medullary cords/Plasma cells,Afferent lympati
11、cs Sinuses Efferent lympatic 输入淋巴管 淋巴窦 输出淋巴管 SINUSES: Supcapsular/Peripheral S 包膜下窦/边缘窦 Paratrabecular/Intermediate S 小梁旁窦/中间窦 Sinus histiocytes Medullary S 髓窦 Hilar S 门窦 Artery Capillaryies Postcapillary venules(PCV *) Vein 动脉 毛细血管 毛细血管后小静脉 静脉 *PCV=Postcappillary venules (High endothelial venules,HEV 高内皮小静脉 / Epithelioid venules,EV上皮样小静脉 ) in the paracortex: permitting lymphocytes to traffic through them/ recirculation passage of lymphocytes,Lymph drainage 淋巴引流/ Blood circulation血液循环,Sinus,Marginal sinus,S,Sinus histiocytes,PCV,
