Starr Amy, Kwon Dong Hyang, Kallakury Bhaskar
1 MedStar Georgetown University Hospital, Washington, DC, USA.
Int J Surg Pathol. 2019 Feb;27(1):98-101. doi: 10.1177/1066896918784669. Epub 2018 Jul 3.
Diffuse large B-cell lymphoma (DLBCL) is characterized by medium- to large-sized neoplastic cells that express a wide range of B-cell markers including CD19, CD20, CD22, and CD79a. Also, as this is a hematopoietic malignancy, there is expression of the leukocyte common antigen CD45. Lack of CD20 expression occurs in a specific rare heterogeneous subgroup of DLBCL including primary effusion lymphoma, plasmablastic lymphoma, ALK-positive large B-cell lymphoma, and large B-cell lymphoma arising in HHV8+ multicentric Castleman disease. In this article, we report a rare case of CD20- and CD45-negative Epstein-Barr virus-positive DLBCL in which the entities listed above were ruled out, thereby posing a significant diagnostic challenge. Arriving at the correct diagnosis of Epstein-Barr virus-positive DLBCL was supported by immunoreactivity for the B-cell transcription factor Oct-2 and the pan-B cell marker CD79a.
弥漫性大B细胞淋巴瘤（DLBCL）的特征是中等至大型肿瘤细胞，这些细胞表达多种B细胞标志物，包括CD19、CD20、CD22和CD79a。此外，由于这是一种造血系统恶性肿瘤，还表达白细胞共同抗原CD45。DLBCL的一个特定罕见异质性亚组，包括原发性渗出性淋巴瘤、浆母细胞性淋巴瘤、ALK阳性大B细胞淋巴瘤以及HHV8+多中心Castleman病中发生的大B细胞淋巴瘤，会出现CD20表达缺失。在本文中，我们报告了一例罕见的CD20和CD45阴性的爱泼斯坦-巴尔病毒阳性DLBCL病例，其中排除了上述实体，从而带来了重大的诊断挑战。B细胞转录因子Oct-2和泛B细胞标志物CD79a的免疫反应性支持了对爱泼斯坦-巴尔病毒阳性DLBCL的正确诊断。
