Iravani S, Singleton T P, Ross C W, Schnitzer B
Department of Pathology, University of Michigan Medical School, Ann Arbor 48109-0602, USA.
Am J Clin Pathol. 1999 Dec;112(6):836-43. doi: 10.1093/ajcp/112.6.836.
Precursor B lymphoblastic lymphoma is an aggressive but potentially curable disease. This lymphoma most often manifests in the skin and lymph nodes and, less commonly, as lytic bone lesions. In the bone, this lymphoma must be differentiated from small round blue cell tumors, diffuse large B-cell lymphoma, and acute myelogenous leukemia. We describe the morphologic and immunophenotypic features in 4 patients, 2 children, 1 teenager, and 1 adult, who initially presented with bone pain and osteolytic lesions but without peripheral blood or iliac bone marrow involvement. Positive immunohistochemical staining of the neoplastic cells was observed for anti-CD10 (3/4), CD20 (3/4), CD34 (1/4), CD43 (4/4), CD45/CD45RB (2/4), CD79a (4/4), CD99 (MIC2) (2/4), and terminal deoxynucleotidyl transferase (4/4). CD3 was absent in all cases. Immunophenotyping these neoplasms is essential to establish the correct diagnosis of precursor B lymphoblastic lymphoma, and a panel of antibodies is required because of the immunophenotypic heterogeneity.
前驱B淋巴细胞淋巴瘤是一种侵袭性但有可能治愈的疾病。这种淋巴瘤最常表现在皮肤和淋巴结，较少见的表现为溶骨性骨病变。在骨骼中，这种淋巴瘤必须与小圆形蓝细胞肿瘤、弥漫性大B细胞淋巴瘤和急性髓性白血病相鉴别。我们描述了4例患者（2例儿童、1例青少年和1例成人）的形态学和免疫表型特征，这些患者最初表现为骨痛和溶骨性病变，但无外周血或髂骨髓受累。肿瘤细胞的免疫组化染色显示抗CD10（3/4）、CD20（3/4）、CD34（1/4）、CD43（4/4）、CD45/CD45RB（2/4）、CD79a（4/4）、CD99（MIC2）（2/4）和末端脱氧核苷酸转移酶（4/4）呈阳性。所有病例中均无CD3表达。对这些肿瘤进行免疫表型分析对于正确诊断前驱B淋巴细胞淋巴瘤至关重要，由于免疫表型的异质性，需要一组抗体。
