Sasaki Yohei, Murai So, Okamura Reiko, Uesugi Yuka, Shimada Shotaro, Watanuki Megumi, Fujiwara Shun, Kawaguchi Yukiko, Arai Nana, Yanagisawa Kouji, Honma Mayumi, Yamochi Toshiko, Hattori Norimichi
Division of Hematology, Department of Medicine, Showa University School of Medicine.
Department of Pathology, Showa University School of Medicine.
Rinsho Ketsueki. 2023;64(1):42-48. doi: 10.11406/rinketsu.64.42.
A 75-year-old man who had lymphadenopathy was admitted to our hospital. Histopathological examination of cervical lymph node biopsy specimens showed diffuse proliferation of lymphoma cells with large nuclei. In immunohistochemistry, the lymphoma cells were positive for CD5, CD10, CD20, BCL2, BCL6, and MYC. The patient was diagnosed with CD5- and CD10-positive diffuse large B-cell lymphoma (DLBCL). MYD88 mutations have been detected in DLBCL. Partial response was achieved after six courses of R-THP-COP therapy. However, the patient died because of disease progression 18 months after the diagnosis. On autopsy, lymphoma cells were found in the lymph nodes throughout the body, central nervous system, adrenals, and skin. CD5- and CD10-positive DLBCL account for 0.5-1% of DLBCL cases and have a very poor disease prognosis. This is a rare case of CD5- and CD10-positive DLBCL with MYC and BCL2 expressions harboring MYD88 mutation.
一名患有淋巴结病的75岁男性入住我院。颈部淋巴结活检标本的组织病理学检查显示，淋巴瘤细胞呈大核弥漫性增殖。免疫组织化学检查显示，淋巴瘤细胞CD5、CD10、CD20、BCL2、BCL6和MYC呈阳性。该患者被诊断为CD5和CD10阳性弥漫性大B细胞淋巴瘤（DLBCL）。在DLBCL中已检测到MYD88突变。经过六个疗程的R-THP-COP治疗后取得部分缓解。然而，患者在诊断后18个月因疾病进展死亡。尸检发现全身淋巴结、中枢神经系统、肾上腺和皮肤均有淋巴瘤细胞。CD5和CD10阳性DLBCL占DLBCL病例的0.5%-1%，疾病预后很差。这是一例罕见的伴有MYC和BCL2表达且携带MYD88突变的CD5和CD10阳性DLBCL。
