Department of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
Pathol Int. 2009 Dec;59(12):868-73. doi: 10.1111/j.1440-1827.2009.02457.x.
Herein is reported a case of plasmablastic lymphoma (PBL) of the retroperitoneum in an HIV-negative patient. This is the first reported case of PBL at this location and of PBL from Japan in the English-language literature. A 76-year-old Japanese man was admitted to hospital with a chief complaint of right inguinal lymph node swelling. Lymph node biopsy indicated large tumor cells with both diffuse and cohesive growth patterns, and conspicuous tumor cell proliferation in lymph node sinuses. The initial pathological diagnosis was metastatic carcinoma. The patient died approximately 1 month after admission, and autopsy showed that the main lesion was a very large retroperitoneal mass. On histology diffusely proliferated plasmablast-like or immunoblast-like tumor cells were identified, which were positive on immunohistochemistry for CD138 and negative for B-cell and epithelial markers. Approximately 90% of the tumor cells were positive for Ki-67. Tumor cells were diffusely positive for EBV-encoded small RNA on in situ hybridization. The autopsy findings suggested a diagnosis of PBL. Accordingly, PBL should be considered as a differential diagnosis when lymph node biopsy findings resemble those of the present patient.
本文报道了一例 HIV 阴性患者腹膜后部位的浆母细胞淋巴瘤（PBL）。这是首例报道的该部位 PBL 病例，也是首例在英语文献中报道的来自日本的 PBL 病例。一名 76 岁的日本男性因右腹股沟淋巴结肿大为主诉入院。淋巴结活检显示大肿瘤细胞呈弥漫性和黏附性生长模式，淋巴结窦内有明显的肿瘤细胞增殖。最初的病理诊断为转移性癌。患者入院后约 1 个月死亡，尸检显示主要病变为非常大的腹膜后肿块。组织学上弥漫性增殖的浆母细胞样或免疫母细胞样肿瘤细胞被识别，免疫组化染色 CD138 阳性，B 细胞和上皮标志物阴性。约 90%的肿瘤细胞 Ki-67 阳性。原位杂交显示肿瘤细胞 EBV 编码的小 RNA 弥漫阳性。尸检结果提示诊断为 PBL。因此，当淋巴结活检结果类似于本例患者时，应将 PBL 作为鉴别诊断之一。
