Department of Pathology, People's Liberation Army 152 Hospital, Room 42, Jianshe Road, Pingdingshan, 467000, Henan, China.
Department of General Surgery, People's Liberation Army 152 Hospital, Room 42, Jianshe Road, Pingdingshan, 467000, Henan, China.
Int J Hematol. 2011 Feb;93(2):247-252. doi: 10.1007/s12185-011-0773-3. Epub 2011 Feb 1.
We present a 62-year-old Chinese woman with histiocytic sarcoma (HS) and diffuse large B cell lymphoma (DLBL) located in the stomach. HS showed abundant eosinophilic cytoplasm with large, pleomorphic nuclei. Tumor giant and multinucleated cells were also prominent. Hemophagocytosis was common in the neoplastic cells. These cells were positive for CD68, CD45RO, and leukocyte common antigen (LCA), partly positive for S-100 and lysozyme, and negative for CD3, CD5, CD20, Pax-5, CD79a, CD1a, CD21, CD35, CD34, myeloperoxidase, HMB45 and cytokeratin (CK). These cells invaded the submucosa, muscularis mucosa, and serosa. DLBL was located in the mucosa and engulfed the covering epithelium and gland. The nuclei of tumor cells were medium-to-large in size, being ≥twice the size of normal lymphocytes. They were diffusely positive for CD20, Pax-5, and LCA, partly positive for vimentin, CD79a, CD10, CD30, CD15, and epithelial membrane antigen, and negative for S-100, CD1a, CD21, CD5, cyclin D1, CD23, CD35, HMB45, and CD68. Both types of tumor cell were positive for Oct-2, Bcl-2, and Bcl-6. These results suggest that HS may have shared a common clonal origin with DLBL, or may have transdifferentiated from DLBL The patient refused further chemotherapy, and died 7 months after surgical resection.
我们现报告一例 62 岁的中国女性患者，其胃内同时患有组织细胞肉瘤（HS）和弥漫性大 B 细胞淋巴瘤（DLBL）。HS 表现为丰富的嗜酸性细胞质，具有大而多形性核。肿瘤巨细胞和多核细胞也很突出。肿瘤细胞常见噬血现象。这些细胞 CD68、CD45RO 和白细胞共同抗原（LCA）阳性，部分 S-100 和溶菌酶阳性，CD3、CD5、CD20、Pax-5、CD79a、CD1a、CD21、CD35、CD34、髓过氧化物酶、HMB45 和细胞角蛋白（CK）阴性。这些细胞侵犯黏膜下层、黏膜肌层和浆膜层。DLBL 位于黏膜内，包绕覆盖上皮和腺体。肿瘤细胞核大小中等至较大，是正常淋巴细胞的两倍以上。它们弥漫性 CD20、Pax-5 和 LCA 阳性，部分 vimentin、CD79a、CD10、CD30、CD15 和上皮膜抗原阳性，S-100、CD1a、CD21、CD5、cyclin D1、CD23、CD35、HMB45 和 CD68 阴性。两种类型的肿瘤细胞均 Oct-2、Bcl-2 和 Bcl-6 阳性。这些结果表明 HS 可能与 DLBL 具有共同的克隆起源，或者可能由 DLBL 转化而来。患者拒绝进一步化疗，术后 7 个月死亡。
