Cheng Fei, Yu Fang, Wang Xiaoxi, Huang Ke, Lu Hongsheng, Wang Zhaoming
71069The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
56709Taizhou Central Hospital, Taizhou, Zhejiang, China.
Int J Surg Pathol. 2021 Dec;29(8):906-914. doi: 10.1177/10668969211013402. Epub 2021 May 3.
Histiocytic/dendritic cell tumors are rare in clinical practice. It is postulated that they originate from bone marrow stem cells. Accumulating evidence has established the existence of immunoglobulin gene and T-cell receptor gene rearrangements in these tumors. Cases of transdifferentiation across lineages from follicular lymphoma to histiocytic/dendritic cell tumors have also been reported. Herein, we report 2 adult males with histiocytic neoplasms coexisting with B-cell lymphoma. Laser capture microdissection and capillary electrophoresis polymerase chain reaction analysis revealed comparable immunoglobulin gene rearrangement in both patients. In one case, chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), Langerhans cell sarcoma, and histiocytic sarcoma coexisted in the lymph nodes. 11q22 deletion often present in CLL/SLL and expression of the gene was detected in all the 3 components. In the other case, there diffuse large B-cell lymphoma and histiocytic sarcoma coexisted in the spleen. Forty-seven mutated genes commonly found in B-cell lymphoma were detected by next-generation sequencing. In the same line, , , , , and genes were found to have similar mutation sites. The results of this study will contribute in providing new ideas for targeted treatment of these diseases.
组织细胞/树突状细胞肿瘤在临床实践中较为罕见。据推测,它们起源于骨髓干细胞。越来越多的证据证实这些肿瘤中存在免疫球蛋白基因和T细胞受体基因重排。也有报道称存在从滤泡性淋巴瘤向组织细胞/树突状细胞肿瘤跨谱系转分化的病例。在此,我们报告2例成年男性患有组织细胞肿瘤并与B细胞淋巴瘤共存。激光捕获显微切割和毛细管电泳聚合酶链反应分析显示,两名患者的免疫球蛋白基因重排情况相当。在1例中,慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)、朗格汉斯细胞肉瘤和组织细胞肉瘤在淋巴结中共存。11q22缺失在CLL/SLL中常出现,且在所有3种成分中均检测到该基因的表达。在另1例中,脾脏中同时存在弥漫性大B细胞淋巴瘤和组织细胞肉瘤。通过二代测序检测到47个在B细胞淋巴瘤中常见的突变基因。同样,发现 、 、 、 和 基因具有相似的突变位点。本研究结果将为这些疾病的靶向治疗提供新思路。