Haycocks Neil G, Zhao X Frank
Department of Pathology, University of Maryland Medical Center Baltimore, MD, USA.
Int J Clin Exp Pathol. 2010 Oct 11;3(8):815-21.
Large B-cell lymphoma presents with the most varied infiltrating patterns and morphologies. Here we report two cases of unusual large B-cell lymphoma in two old female patients. Both lymphomas show: 1) scattered and clustered large B-cells infiltrating the periphery of polyclonal lymphoid nodules; 2) large B-cells with an immunoblastic morphology; 3) large B-cell infiltration associated with vascular proliferation; 4) coexisting lymphoid nodules with hyaline vascular proliferation. The first case took an aggressive clinical course with transformation into acute leukemia, and imparted a short patient survival, whereas the second case responded to chemotherapy, experienced a local recurrence and long survival for >7 years. To our knowledge, these are the first reported cases of large B-cell lymphomas with a paranodular infiltrating pattern, immunoblastic morphology, and associated vascular proliferation.
大B细胞淋巴瘤呈现出最多样化的浸润模式和形态。在此，我们报告两例老年女性患者的不寻常大B细胞淋巴瘤病例。这两种淋巴瘤均表现为：1）散在和成簇的大B细胞浸润多克隆淋巴小结的周边；2）具有免疫母细胞形态的大B细胞；3）与血管增生相关的大B细胞浸润；4）并存伴有透明血管增生的淋巴小结。第一例病例临床过程侵袭性强，转化为急性白血病，患者生存期短，而第二例病例对化疗有反应，经历了局部复发，但存活超过7年。据我们所知，这些是首次报道的具有小结旁浸润模式、免疫母细胞形态且伴有血管增生的大B细胞淋巴瘤病例。
