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盲肠浆母细胞性淋巴瘤:一例伴有细胞学检查结果的病例报告

Plasmablastic lymphoma of the cecum: report of a case with cytologic findings.

作者信息

Hatanaka Kazuhito, Nakamura Naoya, Kishimoto Koji, Sugino Keishi, Uekusa Toshimasa

机构信息

Department of Diagnostic Pathology, Kanto Rosai Hospital, Kawasaki, Japan.

出版信息

Diagn Cytopathol. 2011 Apr;39(4):297-300. doi: 10.1002/dc.21420.

Abstract

Plasmablastic lymphoma (PBL) is a rare lymphoma that is characterized by a diffuse proliferation of large neoplastic cells resembling B immunoblasts, but shows the immunophenotype of plasma cells. PBL is most commonly seen in the oral cavity of human immunodeficiency virus (HIV)-positive patients. Epstein-Barr virus (EBV) may be closely related the pathogenesis of PBL. We report a case of HIV-negative PBL in a 75-year-old man without EBV infection. Histologic examination of the cecal tumor following right hemicolectomy and cytologic examination of ascitic fluid were performed. Cytologic specimens were hypercellular and composed of single cells and loosely formed clusters. Large tumor cells showed plasmacytoid features with basophilic cytoplasm, large nuclei, prominent nucleoli, and focal perinuclear halos. Abnormal mitotic figures were easily identified. On immunohistologic study, the tumor cells were positive for CD138 (plasma cell marker) and kappa, but negative for CD45, CD3, CD20, CD79a, CD56, and cyclin D1. The proliferation index (Ki-67) was high. This is a very rare case of PBL without HIV and EBV infection, involving the cecum.

摘要

浆母细胞淋巴瘤(PBL)是一种罕见的淋巴瘤,其特征为类似B免疫母细胞的大肿瘤细胞弥漫性增殖,但表现出浆细胞的免疫表型。PBL最常见于人类免疫缺陷病毒(HIV)阳性患者的口腔。爱泼斯坦-巴尔病毒(EBV)可能与PBL的发病机制密切相关。我们报告一例75岁未感染EBV的HIV阴性PBL患者。对右半结肠切除术后的盲肠肿瘤进行了组织学检查,并对腹水进行了细胞学检查。细胞学标本细胞过多,由单个细胞和松散形成的细胞团组成。大肿瘤细胞表现出浆细胞样特征,胞质嗜碱性,核大,核仁突出,有局灶性核周晕。易见异常有丝分裂象。免疫组织学研究显示,肿瘤细胞CD138(浆细胞标志物)和κ阳性,但CD45、CD3、CD20、CD79a、CD56和细胞周期蛋白D1阴性。增殖指数(Ki-67)较高。这是一例非常罕见的无HIV和EBV感染、累及盲肠的PBL病例。

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