Wang Di, Zheng Ye, Zeng Dong, Yang Yuexiang, Zhang Xiaonan, Feng Yanling, Lu Hongzhou
1 Department of Pathology, Shanghai Public Health Clinical Center, Fudan University, China.
2 Scientific Research Center, Shanghai Public Health Clinical Center, Fudan University, China.
Int J STD AIDS. 2017 Mar;28(4):380-388. doi: 10.1177/0956462416650124. Epub 2016 Jul 10.
Plasmablastic lymphoma is a rare and aggressive B cell lymphoma that is considered to be strongly associated with HIV infection. This article explores the histological morphology and immunohistochemical characteristics of HIV/AIDS-related plasmablastic lymphoma with the goal of improving the diagnosis and treatment of this rare tumor. According to criteria of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues (2008), six plasmablastic lymphoma cases admitted to the Shanghai Public Health Clinical Center were comprehensively analyzed with conventional hematoxylin-eosin staining, immunohistochemical staining and in situ hybridization. The morphological features of six tumors were consistent with PBL. Immunohistochemical staining showed that all six cases were negative for CD19, CD20, and CD79a, and positive for OCT-2, BOB-1, VS38c, and melanoma ubiquitous mutated 1. The Ki67 proliferation index was higher than 90% in all six cases. In situ hybridization indicated that four cases were EBER-positive. In addition, three cases had C-MYC translocation rearrangement. Our results showed that the immunophenotypes of PBL vary, which makes PBL diagnosis difficult. Therefore, morphological characteristics, immunophenotypic markers, and clinical data should be used in combination to enable an accurate diagnosis, especially in the presence of immunophenotypic variation, as this approach will facilitate timely treatment.
浆母细胞性淋巴瘤是一种罕见的侵袭性B细胞淋巴瘤,被认为与HIV感染密切相关。本文探讨了HIV/AIDS相关浆母细胞性淋巴瘤的组织形态学和免疫组化特征,旨在改善对这种罕见肿瘤的诊断和治疗。根据世界卫生组织造血与淋巴组织肿瘤分类标准(2008年),对上海公共卫生临床中心收治的6例浆母细胞性淋巴瘤病例进行常规苏木精-伊红染色、免疫组化染色及原位杂交综合分析。6例肿瘤的形态学特征符合浆母细胞性淋巴瘤。免疫组化染色显示,6例均CD19、CD20和CD79a阴性,OCT-2、BOB-1、VS38c和黑色素瘤泛素化突变1阳性。6例Ki67增殖指数均高于90%。原位杂交显示4例EBER阳性。此外,3例存在C-MYC易位重排。我们的结果表明,浆母细胞性淋巴瘤的免疫表型各异,这使得浆母细胞性淋巴瘤的诊断困难。因此,应结合形态学特征、免疫表型标志物和临床资料进行准确诊断,尤其是在存在免疫表型变异的情况下,因为这种方法将有助于及时治疗。