Montes-Moreno Santiago, Climent Fina, González de Villambrosía Sonia, González Barca Eva M, Batlle Ana, Insunza Andrés, Pané-Foix María, Colorado Mercedes, Martin-Sánchez Guillermo, Espiga Carlos Richard, Conde Eulogio, Piris Miguel A
Pathology and Hematology Departments, Hospital Universitario Marqués de Valdecilla/IDIVAL, Santander, Spain.
Pathology and Hematology Departments, ICO, Hospital Universitari de Bellvitge, Barcelona, Spain.
Histopathology. 2015 Dec;67(6):918-22. doi: 10.1111/his.12733. Epub 2015 Jun 26.
Here we report two cases of follicular lymphoma that transformed to CD30 positive diffuse large B cell lymphoma and review the literature on this topic.
The first case represents an example of early transformation of conventional low-grade follicular lymphoma to CD30-positive large B cell lymphoma. Immunoglobulin (Ig)H and cytogenetic identity was demonstrated between both components. High-dose and auto-stem cell transplant (SCT) was applied and complete response was achieved. The second case represents an example of d'emblee transformation of intrafollicular neoplasia to CD30-positive large B cell lymphoma. Immunoglobulin K deleting element (IgKde) and cytogenetic identity between both phases was demonstrated. The patient was in partial response after four cycles of rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP).
CD30 expression was found to be associated in these cases to the transformation event and could be considered a therapeutic target to add to conventional immunochemotherapeutic regimens, even in combination with auto-SCT. We suggest looking for CD30 expression in transformed follicular lymphoma cases.
本文报告两例滤泡性淋巴瘤转化为CD30阳性弥漫性大B细胞淋巴瘤的病例，并对该主题的文献进行综述。
第一例代表传统低级别滤泡性淋巴瘤早期转化为CD30阳性大B细胞淋巴瘤的病例。两个成分之间证实了免疫球蛋白（Ig）H和细胞遗传学一致性。应用了高剂量和自体干细胞移植（SCT）并实现了完全缓解。第二例代表滤泡内肿瘤形成突然转化为CD30阳性大B细胞淋巴瘤的病例。两个阶段之间证实了免疫球蛋白K缺失元件（IgKde）和细胞遗传学一致性。患者在接受四个周期的利妥昔单抗联合环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）治疗后部分缓解。
在这些病例中发现CD30表达与转化事件相关，即使与自体SCT联合应用，也可被视为传统免疫化疗方案中增加的一个治疗靶点。我们建议在转化型滤泡性淋巴瘤病例中寻找CD30表达。
