Hayama Miyuki, Niitsu Nozomi, Higashihara Masaaki, Nakamine Hirokazu, Miura Ikuo
Department of Hematology, Kitasato University, Sagamihara-shi, Kanagawa, Japan.
Int J Hematol. 2007 Aug;86(2):147-9. doi: 10.1532/IJH97.07022.
A 68-year-old man presented with systemic lymph node swelling. A biopsy specimen taken from the right cervical lymph node showed that the normal architecture was replaced by a diffuse proliferation of large lymphoid cells with large atypical nuclei. Immunohistochemical analysis showed that the atypical lymphoid cells were positive for CD5, CD10, CD20, CD79a, and Bcl2, and negative for CD3 and cyclin D1. A diagnosis of diffuse large B-cell lymphoma was made. Karyotypic findings included add(5)(q13), del(6)(q13), add(17)(p11), add(19)(p11), add(19)(p13), and t(6;14)(q15;q32). The serum lactate dehydrogenase level and indirect bilirubin level were slightly elevated. Elliptocytosis was observed in the peripheral blood, and a diagnosis of hereditary spherocytosis was made from the family history. Regarding CD5+CD10+ diffuse large B-cell lymphoma with a non-random chromosomal translocation of t(6;14)(q15;q32), studies on the mechanism of lymphomagenesis are needed.
一名68岁男性出现全身淋巴结肿大。取自右侧颈部淋巴结的活检标本显示，正常结构被具有大的非典型核的大淋巴细胞弥漫性增殖所取代。免疫组织化学分析显示，非典型淋巴细胞CD5、CD10、CD20、CD79a和Bcl2呈阳性，CD3和细胞周期蛋白D1呈阴性。诊断为弥漫性大B细胞淋巴瘤。核型分析结果包括5号染色体长臂附加（5）（q13）、6号染色体长臂缺失（6）（q13）、17号染色体短臂附加（17）（p11）、19号染色体短臂附加（19）（p11）、19号染色体短臂附加（19）（p13）以及6号和14号染色体易位（6；14）（q15；q32）。血清乳酸脱氢酶水平和间接胆红素水平略有升高。外周血中观察到椭圆形红细胞增多，根据家族史诊断为遗传性球形红细胞增多症。关于具有非随机染色体易位t（6；14）（q15；q32）的CD5+CD10+弥漫性大B细胞淋巴瘤，需要对淋巴瘤发生机制进行研究。
