[CD20阴性弥漫性大B细胞淋巴瘤合并类风湿关节炎]

[CD20-negative diffuse large B-cell lymphoma complicated by rheumatoid arthritis].

作者信息

Yoshino Teruhiko, Makiyama Junya, Imaizumi Yoshitaka, Matsuo Emi, Kitanosono Hideaki, Nakashima Jun, Kato Takeharu, Miyoshi Hiroaki, Ohshima Koichi, Yoshida Shinichiro, Miyazaki Yasushi

机构信息

Department of Hematology, National Hospital Organization Nagasaki Medical Center.

Clinical Research Center, National Hospital Organization Nagasaki Medical Center.

出版信息

Rinsho Ketsueki. 2020;61(1):33-38. doi: 10.11406/rinketsu.61.33.

DOI:10.11406/rinketsu.61.33

PMID:32023600

Abstract

CD20 antigen is an important marker for diagnosis of B-cell neoplasms that is highly expressed on the surface of neoplastic B lymphocytes. Patients with rheumatoid arthritis (RA) have an increased risk of developing malignant lymphoma, of which diffuse large B-cell lymphoma (DLBCL) is the most common type. We report an unusual case of CD20-negative DLBCL complicated by rheumatoid arthritis. An 81-year old female presented with a left-sided cervical tumor, enlarged tonsil, and polyarticular pain. Pathological findings of the left tonsil showed proliferation of large atypical cells with irregular shaped nuclei. Most large cells were negative for CD3 and CD20. Additionally, these cells were positive for CD79a, BCL2, and MUM1, and negative for CD10, CD138, BCL6, PAX5, EBV-ISH, HHV8, and ALK.. Therefore, she was diagnosed with CD20-negative DLBCL complicated with RA and received dose-modified CHOP that achieved partial remission. Because CD20-negative DLBCL is rare, the identification of the clinicopathological features of this disease is urgently required.

摘要

CD20抗原是诊断B细胞肿瘤的重要标志物，在肿瘤性B淋巴细胞表面高度表达。类风湿关节炎（RA）患者发生恶性淋巴瘤的风险增加，其中弥漫性大B细胞淋巴瘤（DLBCL）是最常见的类型。我们报告一例罕见的CD20阴性DLBCL合并类风湿关节炎的病例。一名81岁女性，出现左侧颈部肿物、扁桃体肿大及多关节疼痛。左侧扁桃体病理检查显示大量非典型细胞增殖，细胞核形态不规则。大多数大细胞CD3和CD20阴性。此外，这些细胞CD79a、BCL2和MUM1阳性，CD10、CD138、BCL6、PAX5、EBV原位杂交、HHV8和ALK阴性。因此，她被诊断为CD20阴性DLBCL合并RA，并接受了剂量调整的CHOP方案治疗，达到部分缓解。由于CD20阴性DLBCL罕见，迫切需要明确该疾病的临床病理特征。