Alapat Daisy V, Ramos Jeanette M, Anderson Julia, Post Ginell R
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
Ann Clin Lab Sci. 2015 Winter;45(1):79-82.
We present the case of a 50-year-old man with nodal diffuse large B-cell lymphoma characterized by CD10, BCL-6, and BCL-2 expression and a complex karyotype, including t(14;18)(q32;q21) and del6q, suggesting transformation from an antecedent follicular lymphoma. Following rituximab-based chemotherapy, residual nodal disease was characterized by a proliferation of plasmacytoid cells positive for CD138, MUM-1, and cytoplasmic kappa light chain. Immunoglobulin heavy chain and kappa light chain gene rearrangement studies detected the same clone in the diagnostic and post-therapy lymph node specimens. This case illustrates the diagnostic utility of B-cell receptor gene rearrangement studies in detecting a clonal relationship in lymphoma cases with extensive morphologic and immunophenotypic variation following chemotherapy.
我们报告了一例50岁男性，患有结节性弥漫性大B细胞淋巴瘤，其特征为CD10、BCL-6和BCL-2表达以及复杂核型，包括t(14;18)(q32;q21)和6q缺失，提示由先前的滤泡性淋巴瘤转化而来。基于利妥昔单抗的化疗后，残留的淋巴结疾病以CD138、MUM-1和细胞质κ轻链阳性的浆细胞样细胞增殖为特征。免疫球蛋白重链和κ轻链基因重排研究在诊断和治疗后的淋巴结标本中检测到相同的克隆。该病例说明了B细胞受体基因重排研究在检测化疗后形态学和免疫表型广泛变异的淋巴瘤病例中的克隆关系方面的诊断效用。
