Shibata D, Nichols P, Sherrod A, Rabinowitz A, Bernstein-Singer L, Hu E
Department of Pathology, Los Angeles County-University of Southern California Medical Center.
Mod Pathol. 1990 Jan;3(1):71-5.
A patient with follicular small cleaved lymphoma presented with an unusual clinical relapse in the central nervous system (CNS) without morphologic evidence of lymphoma cells in the cerebral spinal fluid (CSF). Molecular genetic analysis of the small number of cells in the CSF after in vitro DNA amplification by the polymerase chain reaction demonstrated the presence of an abnormal translocation sequence between chromosomes 14 and 18. A similar translocation could be detected from the original fixed archival lymph node biopsy and from a small proportion of circulating mononuclear cells. These results indicated that occult lymphoma cells were present in the CSF and peripheral blood. Secondary CNS lymphoma involvement was identified at autopsy. This case demonstrates the enhanced sensitivity of lymphoma diagnosis from poorly cellular specimens after in vitro DNA amplification.
一名滤泡性小裂细胞淋巴瘤患者出现中枢神经系统（CNS）异常临床复发，脑脊液（CSF）中无淋巴瘤细胞的形态学证据。通过聚合酶链反应进行体外DNA扩增后，对CSF中少量细胞进行分子遗传学分析，结果显示14号和18号染色体之间存在异常易位序列。从原始固定存档淋巴结活检组织以及一小部分循环单核细胞中也能检测到类似的易位。这些结果表明CSF和外周血中存在隐匿性淋巴瘤细胞。尸检时确定存在继发性CNS淋巴瘤累及。该病例证明了体外DNA扩增后从细胞含量少的标本中诊断淋巴瘤的敏感性增强。
