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HIV 阴性患者胃黏膜浆细胞样淋巴瘤的不典型表现。

Unusual presentation of gastric plasmablastic lymphoma in HIV-negative patient.

机构信息

Clinic for Hematology, Clinical Center of Serbia, 2 Koste Todorovic str, 11000 Belgrade, Serbia.

出版信息

Med Oncol. 2012 Jun;29(2):1186-9. doi: 10.1007/s12032-011-9930-z. Epub 2011 Apr 8.

Abstract

Plasmablastic lymphoma (PBL) has initially been described as a rapidly progressive and almost invariably fatal diffuse large-cell lymphoma with plasmablastic features, exclusively involving the jaw and oral mucosa in HIV-positive patients. Although its clinical features may help in differential diagnosis, an extra-oral localization in a patient without HIV makes it more difficult to suspect clinically. We describe a very rare case of gastric PBL primarily involving stomach in a middle age man without an HIV infection. A biopsy was performed and its findings revealed a diffuse, monomorphous proliferation of the tumor cells with features of immunoblasts, MUM-1, EMA, and lambda light chains positive. Serology was negative for the human immunodeficiency virus (HIV), HBsAg, and hepatitis C virus infection. The patient started treatment with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy, but unfortunately died before the second cycle was given. To our knowledge, this is the second case of gastric PBL presented in HIV-negative patients. The findings in this case suggest that PBL should be included in the differential diagnosis of gastrointestinal tumors.

摘要

浆母细胞淋巴瘤(PBL)最初被描述为一种快速进展且几乎总是致命的弥漫性大 B 细胞淋巴瘤,具有浆母细胞特征,仅累及 HIV 阳性患者的颌骨和口腔黏膜。虽然其临床特征有助于鉴别诊断,但在没有 HIV 的患者中出现口腔外定位会更难以临床怀疑。我们描述了一例非常罕见的胃 PBL 病例,主要累及一名中年男性的胃,且该患者未感染 HIV。进行了活检,其结果显示肿瘤细胞弥漫性单形性增生,具有免疫母细胞、MUM-1、EMA 和 lambda 轻链阳性的特征。血清学检查 HIV、HBsAg 和丙型肝炎病毒感染均为阴性。患者开始接受 CHOP(环磷酰胺、多柔比星、长春新碱和泼尼松)化疗,但不幸的是在进行第二个周期之前死亡。据我们所知,这是第二例在 HIV 阴性患者中出现的胃 PBL。本病例的结果表明,PBL 应纳入胃肠道肿瘤的鉴别诊断。

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