Lin Fan, Zhang Kai, Quiery Albert T, Prichard Jeffrey, Schuerch Conrad
Departments of Laboratory Medicine, Geisinger Medical Center, Danville, Pa 17822, USA.
Arch Pathol Lab Med. 2004 May;128(5):581-4. doi: 10.5858/2004-128-581-PLOTCL.
We report a case of plasmablastic lymphoma presenting in cervical lymph nodes in an 82-year-old, human immunodeficiency virus-negative man. Cytologic and histologic examinations demonstrated a large cell lymphoma with plasmacytic differentiation. The tumor cells were positive for CD138, CD38, epithelial membrane antigen, CD30, and lysozyme, but lacked expression of leukocyte common antigen, T-cell, and B-cell markers. Abundant Epstein-Barr virus-encoded RNA transcripts were identified by in situ hybridization. A monoclonal rearrangement of kappa-light- chain gene was demonstrated. The cytologic, histologic, immunohistochemical, and molecular features of plasmablastic lymphoma are reviewed. The potential diagnostic pitfalls and differential diagnoses, especially in a fine-needle aspiration specimen, are addressed.
我们报告一例82岁的人类免疫缺陷病毒阴性男性患者,其颈部淋巴结出现浆母细胞淋巴瘤。细胞学和组织学检查显示为具有浆细胞分化的大细胞淋巴瘤。肿瘤细胞CD138、CD38、上皮膜抗原、CD30和溶菌酶呈阳性,但缺乏白细胞共同抗原、T细胞和B细胞标志物的表达。通过原位杂交鉴定出大量爱泼斯坦-巴尔病毒编码的RNA转录本。证实了κ轻链基因的单克隆重排。本文对浆母细胞淋巴瘤的细胞学、组织学、免疫组化和分子特征进行了综述。探讨了潜在的诊断陷阱和鉴别诊断,尤其是在细针穿刺标本中的情况。