Peng Hao-Yu, Xiu Ying-Jie, Chen Wei-Hong, Gu Qing-Li, Du Xin
Department of Hematology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China.
Department of Pathology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen 518035, Guangdong Province, China.
World J Clin Cases. 2022 Jun 16;10(17):5877-5883. doi: 10.12998/wjcc.v10.i17.5877.
Follicular lymphoma (FL), a common type of indolent lymphoma, carries markers of the germinal center, and the rearrangement of the gene is regarded as an initiating event and a hallmark of the neoplasm. When FL has marginal zone differentiation, some marginal zone features are carried by the neoplasm.
A 54-year-old male with lymphadenopathy, splenomegaly and hyperlymphocytosis was diagnosed with FL with marginal zone differentiation. The tumor demonstrated different features in the bone marrow (BM) compared with the follicle of the lymph node (LN). Some component of the neoplasm mimicked marginal zone lymphoma, such as infiltrating the marginal zone of the LN, displaying a monocytoid shape and lacking the expression of CD10 in the BM. The diagnosis of FL was made due to the concurrent detection of rearrangement in the LN and BM.
Discordant pathological features in LN and BM could mislead diagnosis. When clinical and pathological manifestations are confusing in diagnosis, typical genetic abnormalities are decisive.
滤泡性淋巴瘤（FL）是一种常见的惰性淋巴瘤，具有生发中心标志物，基因重排被视为肿瘤发生的起始事件和标志。当FL具有边缘区分化时，肿瘤会带有一些边缘区特征。
一名54岁男性，有淋巴结肿大、脾肿大和淋巴细胞增多症，被诊断为具有边缘区分化的FL。与淋巴结（LN）的滤泡相比，肿瘤在骨髓（BM）中表现出不同特征。肿瘤的一些成分类似于边缘区淋巴瘤，如浸润LN的边缘区、呈单核细胞样形态且在BM中缺乏CD10表达。由于在LN和BM中同时检测到重排，故诊断为FL。
LN和BM中不一致的病理特征可能会误导诊断。当临床和病理表现诊断不清时，典型的基因异常具有决定性作用。
