Department of Pathology, University of Colorado Anschutz Medical Center, Aurora 80045; Department of Pathology, City of Hope Medical Center, Duarte, CA 91010.
Hum Pathol. 2013 Oct;44(10):2139-48. doi: 10.1016/j.humpath.2013.04.008. Epub 2013 Jun 20.
Plasmablastic transformation of low-grade B-cell lymphoproliferative disorders is rarely reported, particularly in cases with clonal evolution. Moreover, the relationship of these 2 morphologically and immunophenotypically distinctive neoplasms remains elusive. Here, we report 2 exceptional cases of plasmablastic transformation with apparently direct transformation from their preceding low-grade B-cell lymphoproliferative disorder. In both cases, the plasmablastic transformation and low-grade lymphoproliferative disorder shared the same immunoglobulin heavy chain gene rearrangements and an identical chromosomal translocation. Notably, both plasmablastic transformation cases also carried MYC gene rearrangements on chromosome 8q24, which have been frequently identified in de novo plasmablastic lymphoma. Therefore, our data suggest that dysregulation of MYC gene may play a critical role in the pathogenesis of plasmablastic transformation.
低级别 B 细胞淋巴增生性疾病的浆母细胞转化很少见，尤其是在伴有克隆演变的病例中。此外，这两种形态学和免疫表型明显不同的肿瘤之间的关系仍难以捉摸。在这里，我们报告了 2 例异常的浆母细胞转化病例，其明显是从前一个低级别 B 细胞淋巴增生性疾病直接转化而来。在这两种情况下，浆母细胞转化和低级别淋巴增生性疾病共享相同的免疫球蛋白重链基因重排和相同的染色体易位。值得注意的是，这两种浆母细胞转化病例均在 8q24 染色体上携带 MYC 基因重排，该重排在新发性浆母细胞淋巴瘤中经常被发现。因此，我们的数据表明，MYC 基因的失调可能在浆母细胞转化的发病机制中发挥关键作用。
