Al Houri Hasan Nabil, Ahmad Tagrid Younes, Adden Sarah Zaher, Assad Wisam Hikmat, Raiy Ammar
Department of Internal Medicine, Al Assad University Hospital and Al Mouwasat University Hospital, Damascus, Syria.
Department of Internal Medicine, Tishreen Hospital, Damascus, Syria.
Int J Hematol Oncol Stem Cell Res. 2019 Jan 1;13(1):2-6.
T-Cell Rich B-Cell Lymphoma (TCRBCL) is relatively a new entity, lately classified as a morphologic variant of Diffuse Large B-cell lymphomas (DLBCL). It consists (1-3) % of all B-cell lymphomas. The rate is far less when describing cases of primary splenic involvement with TCRBCL. Pathologically, TCRBCL is described as a limited number of scattered, large, atypical b-cells embedded in a background of abundant t-cells and frequently histiocytes. The similarity of this malignancy with other types makes it difficult to distinguish between them. Thus, it needs expertise in both clinical and pathological fields to make the right diagnosis.Here, we present a case of an adult male patient whose first presentation and previous medical history of renal colic misguided the initial diagnosis and suggested another colic episode as the underlying ailment. However, further physical, radiological and histopathological investigations uncovered the presence of primary TCRBCL within spleen with no involvement of other sites. Moreover, unusual pathologic finding of CD3 positivity was proved by immunohistochemistry.
富含T细胞的B细胞淋巴瘤(TCRBCL)是一种相对较新的实体,最近被归类为弥漫性大B细胞淋巴瘤(DLBCL)的一种形态学变异型。它占所有B细胞淋巴瘤的(1 - 3)%。在描述原发性脾脏受累的TCRBCL病例时,这一比例要低得多。病理上,TCRBCL被描述为在大量T细胞和常常还有组织细胞的背景中散在分布的数量有限的大的非典型B细胞。这种恶性肿瘤与其他类型的相似性使得难以将它们区分开来。因此,需要临床和病理领域的专业知识才能做出正确诊断。在此,我们报告一例成年男性患者,其最初表现为肾绞痛且既往病史误导了初步诊断,提示另一次绞痛发作是潜在疾病。然而,进一步的体格检查、影像学检查和组织病理学检查发现脾脏存在原发性TCRBCL,其他部位未受累。此外,免疫组织化学证实了CD3阳性这一不寻常的病理发现。