Hirzel Alicia C, Cotrell Aaron, Gasparini Robert, Sriganeshan Vathany
Mount Sinai Medical Center, A.M. Rywlin, Department of Pathology and Laboratory Medicine, 4300 Alton Road, Suite 2200, Miami Beach, FL 33140, USA.
Case Rep Pathol. 2013;2013:679892. doi: 10.1155/2013/679892. Epub 2013 Mar 6.
Acute lymphoblastic leukemia is predominantly found in children. It is a neoplasm of precursor cells or lymphoblasts committed to either a B- or T-cell lineage. The immature cells in B-acute lymphoblastic leukemia/lymphoma can be small or medium sized with scant or moderate cytoplasm and typically express B-cell markers such as CD19, cytoplasmic CD79a, and TdT without surface light chains. These markers, along with cytogenetic studies, are vital to the diagnosis, classification, and treatment of these neoplasms. We present an unusual case of a precursor B-cell ALL, in an 82-year-old woman, who presented with pancytopenia and widespread lymphadenopathy. The cells show L3 morphology (Burkitt-like lymphoma) with coexpression of TdT and surface light chains in addition to an MYC gene translocation and Philadelphia chromosome.
急性淋巴细胞白血病主要见于儿童。它是一种起源于前体细胞或淋巴母细胞的肿瘤，这些细胞定向分化为B细胞或T细胞谱系。B急性淋巴细胞白血病/淋巴瘤中的未成熟细胞可以是小或中等大小，细胞质稀少或中等，通常表达B细胞标志物，如CD19、细胞质CD79a和末端脱氧核苷酸转移酶（TdT），而无表面轻链。这些标志物，连同细胞遗传学研究，对这些肿瘤的诊断、分类和治疗至关重要。我们报告一例罕见的前体B细胞急性淋巴细胞白血病病例，患者为一名82岁女性，表现为全血细胞减少和广泛淋巴结病。细胞显示L3形态（伯基特样淋巴瘤），除了MYC基因易位和费城染色体外，还共表达TdT和表面轻链。
