´ØÏ¢¥Ú¡¼¥¸¡§agressive natural killer cell leukemia?, ¡¡Natural killer cells (NK cells)

ÁÈ¿¥²èÁü¤Ï¥µ¥à¥Í¥¤¥ë¤ò¥¯¥ê¥Ã¥¯¤¹¤ë¤ÈÂ礭¤Ê²èÁü¤¬¸«¤é¤ì¤Þ¤¹.

Extranodal Natural Killer(NK)/T-Cell Lymphoma, Nasal Type

Case01:

76year-old female. £±½µ´ÖÁ°¤è¤êÉ¡½Ð·ì¤¬¤¢¤ê¼õ¿Ç. É¡¹ÐÆâ¤Ë¼ðáî¤òǧ¤á¤¿¡£

flowcytometry data¡¡ enhaCT01.jpg(113.7KB) ¡¡¡¡CT¤Ç¤Ï±¦ÃæÉ¡Æ»¤òËä¤á¤ë¤è¤¦¤Ê¼ðáǧ¤á¤é¤ì¤ë¡£

À¸¸¡ÁÈ¿¥¤ÎCD45¥²¡¼¥Æ¥£¥ó¥°flowcytometryʬÀϤǤÏCD2+, CD56+, CD16+, HLA-DR+¡£CD30, CD25ÍÛÀ­¤ÎºÙ˦¤¬ÉôʬŪ¤Ëǧ¤á¤é¤ì¤ë¡£sCD3¤Ï±¢À­, CD7¤â¤Û¤È¤ó¤É¤¬±¢À­. ¼ðáçºÙ˦¤ÏNKºÙ˦ͳÍè¤È¹Í¤¨¤é¤ì¤ë¡£

CD16

  • CD16¤ÏIgG¤ÎÄã¿ÆÏÂÀ­¥ì¥»¥×¥¿¡ÊFc¦ÃR­·¡Ë¤Ç¡¢Fc¦ÃR­·A¡Ê¤Þ¤¿¤Ï­·-2¡Ë¤ÈFc¦ÃR­·B¡Ê¤Þ¤¿¤Ï­·-1¡Ë¤Î2¼ïÎà¤Î°äÅÁ»Ò¤Ç¥³¡¼¥É¤µ¤ì¤Æ¤¤¤ë¥¢¥¤¥½¥Õ¥©¡¼¥à¤¬¤¢¤ë.
  • CD16°äÅÁ»Ò¿·¿¤Ë¤è¤ê°Û¤Ê¤ëË쥿¥ó¥Ñ¥¯¤¬»ºÀ¸¤µ¤ì, ¤Ò¤È¤Ä¤ÏËì´ÓÄÌ·¿¥¢¥¤¥½¥Õ¥©¡¼¥à¡ÊFc¦ÃR­·A¡¢Ê¬»ÒÎÌ50-65kDa¡Ë¤Ç¡¢NKºÙ˦¤äñµå¡¢¥Þ¥¯¥í¥Õ¥¡¡¼¥¸¤Ëȯ¸½¤¹¤ë¡£¤â¤¦¤Ò¤È¤Ä¤Ï¥°¥ê¥³¥·¥ë-¥Õ¥©¥¹¥Õ¥¡¥Á¥¸¥ë¥¤¥Î¥·¥È¡¼¥ë¡ÊGPI¡Ë·ë¹ç·¿¥¢¥¤¥½¥Õ¥©¡¼¥à¡ÊFc¦ÃR­·B1¡¢Ê¬»ÒÎÌ48kDa¡Ë¤Ç¡¢¹¥Ãæµå¤Î¤ß¤Ëȯ¸½¤¹¤ë¡£
    NKºÙ˦¤Ç¤Ï¡¢Ê¬»ÒÎÌ16kD¤ÎCD3¦Æº¿¤ÈFc¦ÅR¦Ãº¿¤Î¥Û¥â/¥Ø¥Æ¥í¥À¥¤¥Þ¡¼¤ËCD16ʬ»Ò¤¬Èó¶¦Í­·ë¹çŪ¤Ë²ñ¹ç¤·¤¦¤ë¤³¤È¤¬ÌÀ¤é¤«¤Ë¤µ¤ì¤Æ¤¤¤ë¡£
 

ɡǴËì¼ðáîÀ¸¸¡ÁÈ¿¥ÉÂÍý½ê¸«

NKL05.jpg(255.0KB)¡¡NKL04.jpg(191.4KB)¡¡NKL03.jpg(209.5KB)

Ãæ¤Ê¤¤¤·Âç·¿°Û·¿¥ê¥ó¥ÑµåÍͺÙ˦¤¬¥·¡¼¥È¾õÌ©¤ËÁý¿£¤·¤Æ¤¤¤ë¡£³Ë¤Ë¤Ï¤·¤ï¡¢¤Í¤¸¤ì¤ä¤¯¤Ó¤ì¤¬Ç§¤á¤é¤ì¥¯¥í¥Þ¥Á¥ó¤ÏÁƤ¯¡¢³Ë¾®ÂΤ¬½Ð¸½¤·¤Æ¤¤¤ë¡£

NKLEL02.jpg(254.2KB) ɡǴËìÁ£´É¤Ø¤Î¥ê¥ó¥Ñ¼ðºÙ˦¿»½á(LEL)¤¬¸«¤é¤ì¤¿¡£

CD56 ¡¡CD3ok.jpg(252.6KB) ¡¡EBER-ISH CD56(º¸), CD3¦Å(Ãæ), EBER-ISH(±¦)

 

ÉÂÍýÁÈ¿¥¿ÇÃÇ¡§extranodal NK/T-cell lymphoma, nasal type

Á´¿È²½³ØÎÅË¡, ¶É½êÊü¼ÍÀþÎÅË¡¤Ë¤è¤ê´²²ò¡£°Ê¸å²èÁü¤Ê¤É¤Çfollow up¤¹¤ë¡£6ǯ¸å¤â̵ÉÂÀ¸Â¸¡£

 
 

Case02 ÀºÁã¼ðáî

87year-old male

±¦âдݤμðÂç¤ò¼«³Ð¡£±¦ÀºÁã¤Ï¹Å¤¯·ÚÅÙ¼ðÂ礷¤Æ¤¤¤ë¡£CT¤Ç¤Ï¶Ñ°ì¤ÊÀºÁã¤Î¼ðÂç¤ÈÁ´¿È¥ê¥ó¥ÑÀá¤Î·ÚÅÙ¼ðÂç¤ò»ØÅ¦¤µ¤ì°­À­¥ê¥ó¥Ñ¼ð¤¬µ¿¤ï¤ì¤ë¡£sIL-2R 5990¤È¾å¾º(Àµ¾ïÃÍ145-519).

±¦âдÝŦ½ÐɸËÜÉÂÍý½ê¸«

ÀºÁã, ÀºÁã¾åÂΤòÀêµò¤¹¤ë¼ðáç. ²õ»à½Ð·ì¤Ï¤ß¤é¤ì¤Ê¤¤¡¡testisNK01.jpg(118.8KB)

 
 

°à½Ì¤·¤¿ÀººÙ´É¼þ°Ï¤Ë°Û·¿¥ê¥ó¥Ñµå¤¬Ì©¤Ë¿»½á¤·¤Æ¤¤¤ë. ·ì´ÉÃæ¿´¿»½áÁü¤òǧ¤á¤ë.

HE02.jpg(330.5KB)¡¡¡¡HE03.jpg(330.0KB)¡¡¡¡HE09.jpg(285.4KB)¡¡¡¡HE07.jpg(332.1KB)

 
 

¼ðáçºÙ˦¤Ïº¸¤«¤éCD3¦Å, CD56, EBER-ISH, granzymeBÍÛÀ­¤ò¼¨¤¹¡£

testisNKCD3.jpg(266.1KB)¡¡¡¡CD56¡¡¡¡EBER-ISH¡¡¡¡granzymeB

ÉÂÍýÁÈ¿¥¿ÇÃÇ: extranodal NK/T lymphoma, nasal type of the rt. testis

 
 

Case03 °öƬɡ¹ÐÉÂÊÑ--Ã×»àÀ­ÀµÃæÀ­Æù²ê¼ð¤ÎÁÈ¿¥Áü

 
sagitalview.jpg

80yo male. 1¥ö·îÁ°¤è¤êÓë²¼»þÄˤ¬¤¢¤ê¶á°å¼õ¿Ç. º¸Æð¸ý³¸Ç´Ëì¼ðı¤È¤Ó¤é¤ó, º¸É¡Á°ÄíÉô¼¾¿¾, ÃæÉ¡Æ»¤«¤é¤ÎÇ¿½ÁÇÓÝõ¤ò¤ß¤È¤á¤¿¡£ºÇ½é¥Ø¥ë¥Ú¥¹´¶À÷¾É¤ÈµÞÀ­ÉûÉ¡¹Ð±ê¤È¿ÇÃǤµ¤ì¼£ÎŤò¼õ¤±¤ë¤¬Æð¸ý³¸¼ðı¤¬Áý¶¯¤·¤¿¡£Aɱ¡¤ò¾Ò²ð¤µ¤ì°öƬ¤«¤éÆð¸ý³¸¤Ë¤«¤±ÄÙáç¤òȼ¤¦¼ðáî¤ò»ØÅ¦¤µ¤ì¤ë¡¢Æ±Éô¤è¤êÀ¸¸¡¤ò¤ª¤³¤Ê¤¤NK/T cell lymphoma¤È¿ÇÃǤµ¤ì¤¿. (Äó¼¨ÁÈ¿¥¤Ï¤½¤Î»þ¤Î¤â¤Î¡£Ä󶡤µ¤ì¤¿¥Ö¥í¥Ã¥¯¤è¤êºÆÀ÷¿§ÌȱÖÀ÷¿§¤·¤Þ¤·¤¿)¡£
Ʊ±¡¤ÇÎ×¾²¥¹¥Æ¡¼¥¸2B°Ê¾å¡¢¶É½êÊü¼ÍÀþ¼£ÎŤÎŬ±þ¤¢¤ê¤È¤µ¤ìÅö±¡¤ò¾Ò²ð¤µ¤ì¤ë¡£Í象»þ(¾É¾õȯÀ¸¤è¤êÌó2¥ö·î)¤Ë¤Ï40¡îÂæ¤ÎȯǮ, °Õ¼±º®Âù¤¢¤ê¡£º¸¼ª²¼Á£Éô¤ËµðÂç¤Ê¼ðáçÀ­Éâ¼ð, ´éÌ̤¬ÊÑ·Á, ¾å¸ý³¸¤¬ÆÍ½Ð¤¹¤ë¤Û¤É¤Î¼ðáçÁýÂç¤È°öƬÉô²½Ç¿¤¬Ç§¤á¤é¤ì½ÅÆÆ¤Ê¾õÂ֤Ǥ¢¤ê¶ÛµÞÆþ±¡¡£

noseloupeNK.jpg(200.1KB) ¾Ò²ðɱ¡¤Ç¤ÎÀ¸¸¡ÁÈ¿¥ÊÒ

 

¤Ó¤é¤ó¤ò¼¨¤¹Ù¨Ê¿¾åÈéÇ´ËìÁÈ¿¥ÊÒ¡£±ê¾ÉÀ­Æù²ê¼ðÁÈ¿¥¤¬¾åÈé²¼¤Ëǧ¤á¤é¤ì¤ë¡£¤è¤¯¸«¤ë¤ÈÃæ¤Ê¤¤¤·Âç·¿°Û·¿¥ê¥ó¥Ñµå¤¬¿»½á¤·¤Æ¤¤¤ë¤è¤¦¤Ë¤â¸«¤¨¤ë¤¬¼ðáç¤ÎÃÇÄê¤ÏÆñ¤·¤¤¡£

pharynx01.jpg(478.1KB)¡¡HE¡¡HE

 

CD3, CD20ÍÛÀ­¥ê¥ó¥Ñµå¤Î¿»½á¤Ï¾¯¤Ê¤¯CD56ÍÛÀ­ºÙ˦¤¬Áý²Ã¤·¤Æ¤¤¤ë¡£

CD3¡¡CD20¡¡CD56

 

¤ä¤äback ground¤¬¶¯¤¤¤¬³ËÍÛÀ­¤ò¼¨¤¹EBV´¶À÷ºÙ˦¤¬Â¿¿ôǧ¤á¤é¤ì¤ë¡£¹ü¿ñ¤Ë¤ÏìÅ¿©Áü¤¢¤ê¡£

EBER-ISH¡¡EBERpharynx02.jpg(247.6KB)¡¡HPS01.jpg(159.4KB)

 
 

ÉÂÍýÁÈ¿¥¿ÇÃÇ¡§Nasal NK/T-cell lymphoma, pharynx, biopsy

¹ü¿ñ¤ÏÀµ·ÁÀ­. M/E=2.4. ¥Þ¥¯¥í¥Õ¥¡¡¼¥¸¤ÎÁý²Ã¤¬¤á¤À¤Á·ìµåìÅ¿©Áü3.0%. 3·ÏÅý¤·ìºÙ˦¤È¤â¤Ë³ÆÀ®½ÏÃʳ¬¤¬¤ß¤é¤ì°Û·ÁÀ­¤Ê¤·. °Û·¿ºÙ˦Áý¿£¤â¤ß¤é¤ì¤Ê¤¤¡£À÷¿§ÂÎ:46XY. ¥ê¥ó¥Ñ¼ð´ØÏ¢·ìµåìÅ¿©¾É¸õ·²¤ËÌ·½â¤Ê¤¤½ê¸«. flowcytometry CD56ÍÛÀ­ºÙ˦½¸ÃĤ¬¤´¤¯¾¯¿ôƱÄꤵ¤ì¤Æ¤¤¤ë. ¶À¸¡¾åÌÀ¤é¤«¤Ê¥ê¥ó¥Ñ¼ðºÙ˦¤Î¿»½á¤ò»ØÅ¦¤Ç¤­¤Ê¤«¤Ã¤¿¡£

NK/TºÙ˦¥ê¥ó¥Ñ¼ð, ¥¹¥Æ¡¼¥¸­¸. ¶É½êÊü¼ÍÀþÎÅË¡¤ÎŬ±þ¤Ï¤Ê¤¯, ´²²òƳÆþÌÜŪ¤ÇÁ´¿È²½³ØÎÅË¡¤ò³«»Ï(DevicÎÅË¡).CT¤ÇPR. °öƬÉôÄÙáç¤Ï½Ì¾®·¹¸þ·ìµåìÅ¿©¤Ï²þÁ±¤»¤º¹âÇ®¤¬´ÖݼŪ¤Ë»ý³¤·¤¿¡£ Devic2¥³¡¼¥¹¤Ë³¤­¥µ¥ë¥Ù¡¼¥¸ÎÅË¡(VeMP)¤ò¤ª¤³¤Ê¤¦¤¬Á´¿È¾õÂÖ°­²½, ½Ð·ì·¹¸þ¤òÍ褿¤·È¯¾É¤«¤é4¥ö·î¸å¤Ë±Ê̲¤µ¤ì¤ë¡£

Extranodal NK/T-cell lymphoma, nasal type

mature NK/T-cell lymphoma¤Î°ì·¿. Îã³°¤Ê¤¯EBV´¶À÷¤È´ØÏ¢¤¹¤ë. ¿Í¼ï¤ÎÁǰø¤¬¤¢¤ê¥¢¥¸¥¢, ¥¢¥á¥ê¥«¸¶½»Ì±¤ËȯÀ¸¤·²¤ÊÆ, Æî¥¢¥¸¥¢, ÃæÅì, ¥¢¥Õ¥ê¥«¤Ë¤Ï¾¯¤Ê¤¤.

85%¤ÏÉ¡¹Ð¤Û¤«¾åÉôµ¤Æ»¾Ã²½´É¤ËȯÀ¸¤¹¤ë. »Ä¤ë15%¤ÏƱÍͤÎÎ×¾²ÉÂÍýÁü¤ò¼¨¤¹Àá³°¥ê¥ó¥Ñ¼ð¤¬¾åµ­°Ê³°¤ÎÉô°Ì¤Ë½Ð¸½¤·, extranasal NK/T-cell lymphoma¤È¸Æ¤Ð¤ì¤ë. NK cellͳÍ褬¤Û¤È¤ó¤É¤Ç¤¢¤ë¤¬T cellͳÍè¤Î¾ÉÎã¤â¤¢¤êNK/T-cell lymphoma¤¬Å¬ÀڤȤµ¤ì¤Æ¤¤¤ë.

Nasal NK/T-cell lymphoma

Extranodal NK/T-cell lymphoma¤Îŵ·¿Îã¤ÏÉ¡¹ÐÎΰè¤ËȯÀ¸¤¹¤ë. ¼ðáçºÙ˦¤ÎºÙ˦¾ã³²À­¤Ë¤è¤êÉ¡, ´éÌÌÀµÃæÉôÁÈ¿¥¤ÎÇ˲õ¤¬¶¯¤¯, Ã×»àÀ­Ãæ¿´À­Æù²ê¼ð(lethal midline granuloma)¤ËʬÎव¤ì¤Æ¤¤¤¿.

  • ÃËÀ­¤Ë¿¤¯È¯À¸Ç¯ÎðÃæ±ûÃͤÏ50ºÐÁ°¸å¤Ç¾®»ù¤Ë¤Ï¾¯¤Ê¤¤. ¾¯¤Ê¤¤¾®»ù¾ÉÎã¤Ç¤Ï²ã¥¢¥ì¥ë¥®¡¼¤äEB¥¦¥¤¥ë¥¹´ØÏ¢¼À´µ¤È´ØÏ¢¤¬¤¢¤ë¤³¤È¤¬Â¿¤¤.
     
  • ¥ê¥ó¥Ñ¼ð¤Ï¤¤¤í¤¤¤í¤ÊÁÈ¿¥Áü¤ò¼¨¤¹. ¿¤¯¤ÎÎã¤Ï¿·¿¤Î¤¢¤ë¾®, Ãæ, Âç·¿°Û·¿¥ê¥ó¥Ñµå¤¬¼ï¡¹¤Î±ê¾ÉÀ­ºÙ˦(·Á¼ÁºÙ˦, ¥Þ¥¯¥í¥Õ¥¡¡¼¥¸, ¹¥Ãæµå)¤Èº®ºß¤·¤ÆÁý¿£¤¹¤ë.
     
  • ²õ»à, ·ì´ÉÃæ¿´¿»½á¤ä·ì´É¿»½á¤¬Ä̾ï¤Î½ê¸«¤Î¤¿¤á°ÊÁ°¤Ïangiocentric lymphoma ¤È¤µ¤ì¤Æ¤¤¤¿¡£
     
  • ¼ðáçºÙ˦¤¬¾®·¿¥ê¥ó¥Ñµå¤Î¤ß¤Ç¹½À®¤µ¤ì, °Û·¿¤ä²õ»à½ê¸«¤¬¤Ê¤¤¾ì¹ç¤ÏÍÆ°×¤ËËýÀ­±ê¾É¤È¸í¿Ç¤µ¤ì¤ë. °ß, ÂçIJ(¾Ã²½´ÉÉÂÊѤǤÏÀü¹¦¾É¾õ¤¬Â¿¤¤), ÈéÉæ¤Ë¤³¤Î¾®·¿¼ðáçºÙ˦¤¬¿»½á¤¹¤ë¾ì¹ç¤Ï¤è¤ê¿ÇÃǤ¬º¤Æñ¤È¤Ê¤ë.
     
  • °Û·¿¤Î¤Ê¤¤¾®¥ê¥ó¥Ñµå¤Î¿»½á¤Ç¤¢¤Ã¤Æ¤â²õ»à¤Î¤¢¤ë¾ì¹ç¤Ï, CD56¤òǰ¤Î¤¿¤áÀ÷¿§¤·¤Æ¤ß¤ë¡£ÆÃ¤ËÉ¡, °öƬ¤ÎÇ´Ëì¤Î¾ì¹ç. -->¾ÉÎã¤ò¤ß¤ë
     
  • ¹ü¿ñÀ¸¸¡¤Ç¤Ï80%¤¬Èù¾®¤ÊÉÂÊѤΤ¿¤á¥ë¡¼¥Á¥ó¤ÎHEɸËܤǤϸ«¤Ä¤±¤é¤ì¤Ê¤¤¤³¤È¤¬Â¿¤¤¡£
     
  • EBER¤Î¸¡½Ð¤¬¥¹¥Æ¡¼¥¸·èÄê¤ä½éȯÉÂÊѤοÇÃǤËÍ­ÍѤȤʤë.

immunophenotype

  • CD2, CD56¤ª¤è¤ÓCD3¦Å¤¬ÍÛÀ­. ɽÌÌCD3(sCD3)¤Ï±¢À­.
     
  • perforin, granzymeB, TIA-1¤ÎºÙ˦¾ã³²À­ðù㤬ÍÛÀ­
     
  • ¤È¤­¤ËCD30, CD7¤¬ÍÛÀ­
  • CD56±¢À­¤ÎNK/T-cell lymphoma¾ÉÎ㤬¤¢¤ë. CD56±¢À­¤Ç, CD4/ CD8¤¬ÍÛÀ­¤ò¼¨¤¹¾ÉÎ㤬¤¢¤ê, Î×¾²ÉÂÂÖ¤ÏÊѤï¤é¤Ê¤¤¤³¤È¤«¤é¤³¤Î¼À´µ¤ËʬÎव¤ì¤Æ¤¤¤ë
  • CD56±¢À­, CD3¦ÅÍÛÀ­¤Î¾ÉÎã¤ÏºÙ˦¾ã³²À­ðùγ¤ÈEBV¤¬EBER-ISH¤ÇÍÛÀ­¤ò³Îǧ¤Ç¤­¤ë¤È extranodal NK/T lymphoma¤È¿ÇÃǤµ¤ì¤ë. ξ¼Ô¤¬±¢À­¤Î¾ì¹ç¤Ïperipheral T cell lymphoma, not othewise specific¤ËʬÎह¤ë.

genotype

  • TCR, Ig gene¤Ïgermline
     
  • TCR¤¬rearrangement¤ò¼¨¤¹¾ÉÎ㤬¾¯¿ô(up to 27%)¤¢¤ë¤¬cytotoxic T cell¤Î¼ðáç¤È¹Í¤¨¤é¤ì¤ë
     
  • p53, c-kit¤Î°äÅÁ»Ò°Û¾ï¤¬»ØÅ¦¤µ¤ì¤Æ¤ª¤êÃϰè¤Ë¤è¤Ã¤ÆÉÑÅ٤κ¹¤¬Ç§¤á¤é¤ì¤ë
     
  • 50%¤Î¾ÉÎã¤Ë¤ÏFas°äÅÁ»ÒÊѰۤ¬Ç§¤á¤é¤ì¤ë
     
  • Ä̾ï¤ß¤é¤ì¤ë³Ë·¿°Û¾ï¤Ï6q deletion¤Ç¤¢¤ë¡£¤·¤Ð¤·¤Ð6q21·ç»¤Ë¤è¤ëHACE1ÍÞÀ©°äÅÁ»Ò¤Îderegulation¤¬·ì´ÉÀ¸Íý¤Î°äÅÁ»Ò, EBV-induced gene, PDGFRA²á¾êȯ¸½¤Ë¤«¤«¤ï¤ë°äÅÁ»Ò¤Ë±Æ¶Á¤·¤Æ¤¤¤ë¤³¤È¤¬¶áǯ¤Îmicroarray¸¦µæ¤Ë¤è¤ê²òÀϤµ¤ì¤Æ¤¤¤ë¡£

prognosis

  • °ìÈ̤Ëͽ¸åÉÔÎÉ. 5À¸Î¨<50%.
  • É¡¹ÐÉÂÊѤÇ, ¹âMIB-1 index >50%, 40%°Ê¾å¤ÎtransformºÙ˦¤Î¸ºß¤Ïͽ¸åÉÔÎɿ䬰ø»Ò¤È¤Ê¤ë¡£É¡¹Ð°Ê³°¤ÎÉô°Ì¤Ë¤ÏŬ±þ¤Ç¤­¤Ê¤¤¡£

Extranasal NK/T-cell lymphoma

  • ÂΤΤ¤¤«¤Ê¤ëÉô°Ì¤Ë¤âȯÀ¸¤¹¤ë. ÈéÉæ, ÆðÉôÁÈ¿¥, ¾Ã²½´É, âÐ´Ý¤ÏÆÃ¤Ë¿¤¤. ´Î, ÇÙ, Ǿ, Æý˼, ´ããÝ, Àå, ÍñÁã, Éû¿ÕȯÀ¸¤ÎÊó¹ð¤â¤¢¤ë.
  • ÈéÉæ¤Ç¤ÏÂ礭¤ÊÄÙáçÉÂÊѤޤ¿¤Ï¿ȯ¤¹¤ë¹ÈÈÃÍͤÎȯ¿¾¤ò¤Ä¤¯¤ë¾ pyogenic granuloma¤Ë»÷¤¿ÉÂÊѤò¤Ä¤¯¤ë¤³¤È¤â¤¢¤ë¡£
  • ¾Ã²½´É¤ÎÉÂÊѤϥݥ꡼¥×¤¢¤ë¤¤¤Ï©Æù¾õ¼ðáî, ÄÙáç, ¿ȯ¤Ó¤é¤ó¤òÄ褹¤ë. ¿Ê¹Ô¤·¤¿¼ðáç¤Ç¤ÏÂç·¿·ëÀáÉÂÊѤägiant fold¤ò¼¨¤¹
  • É¡°Ê³°¤ÎÉÂÊѤÎimmunophenotype, genotype¤Ïnasal NK/T-cell lymphoma¤ÈƱ¤¸¤Ç¤¢¤ë¤¬CD30ÍÛÀ­¤ÎÉÑÅÙ¤¬¹â¤¤¡£
  • À­ÊÌ, ǯÎðʬÉÛ, ÃÏÍýŪʬÉÛ, immunophenotype¤Ï nasal lymphoma¤ÈÊѤï¤é¤Ê¤¤. ͽ¸å¤ÏÉ¡°Ê³°¤ÎÉÂÊѤΤۤ¦¤¬°­¤¤¡£

¥ê¥ó¥ÑÀá¤Ë½éȯ¤·¤¿nasal type NK/T cell lymphoma¾ÉÎã

  • ÀáÀ­¤Ç¤¢¤ì¤ÐÄ̾ï¤ÏPTCL-NOS¤Ç¤¢¤ë¤¬, Îã³°¤¬¤¢¤ë¡Ê?!)
  • ·ÛÉô¥ê¥ó¥ÑÀá¤ÎÊó¹ð¤¬Â¿¤¯¼¡¤¤¤Ç²¼³Ü¥ê¥ó¥ÑÀá¤Ë¤ß¤é¤ì¤ë¤¬Ê£¿ô¤Î¥ê¥ó¥ÑÀáÉÂÊÑÎã¤â¤¢¤ë
  • Á´ÎãÃËÀ­¤Ç, ǯÎðÃæ±ûÃͤÏ55ºÐ
  • ÀáÉÂÊѤÎÁÈ¿¥, ÌȱÖÀ÷¿§½ê¸«¤ÏÀá³°ÉÂÊѤȺ¹¤Ï¤Ê¤¤¤¬TCRºÆ¹½À®¤¬È¾¿ô¤Ëǧ¤á¤é¤ìnasal type¤È¤³¤È¤Ê¤êcytotoxic T cellͳÍ褬¿¤¤(¤³¤Î¾ì¹ç¤Ï, PTCL¤Ç¤Ï¤Ê¤¤¤«¡©¡Ë
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Last-modified: 2020-11-30 (·î) 06:28:34 (59d)