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浆母细胞淋巴瘤的诊断挑战:形态学、免疫组化和流式细胞术结果综合分析的重要性(病例报告)。

A challenging diagnosis of plasmablastic lymphoma: importance of integrating morpholgy immunohistochemistry and flow cytometry findings (case report).

机构信息

Department of Clinical Hematology, Farhat Hached University Hospital, Sousse, 4081, Tunisia.

Department of Cytology, Farhat Hached University Hospital, Sousse, 4081, Tunisia.

出版信息

Pan Afr Med J. 2023 Aug 13;45:158. doi: 10.11604/pamj.2023.45.158.39896. eCollection 2023.

Abstract

Plasmablastic lymphoma (PBL) is a rare clinicopathological entity that still raises many diagnostic and management difficulties, particularly due to the overlap between plasmablastic lymphomas and myeloma features. We report a clinical presentation of PBL affecting bone marrow in a 43-year-old patient who was admitted for B symptoms, hepatosplenomegaly, and bicytopenia investigation. Based on these findings, acute leukemia was suspected. Bone marrow morphology immunohistochemistry and flow cytometry contributed to establishing the diagnosis of medullary PBL. The patient deteriorated and died due to septic shock. This pathology requires collaboration between clinicians, pathologists, and biologists to confirm the diagnosis early. Nevertheless, a delayed diagnosis may contribute to worsening the prognosis particularly due to advanced stage consultation. Our reported case illustrates a rare clinical presentation affecting bone marrow. In our context, a confrontation between flow cytometry and immunohistochemistry was of interest as it helped to detect the immunological features of this neoplasm.

摘要

浆母细胞淋巴瘤(PBL)是一种罕见的临床病理实体,仍然存在许多诊断和管理上的困难,特别是由于浆母细胞淋巴瘤和骨髓瘤特征之间存在重叠。我们报告了一例影响骨髓的 43 岁患者的 PBL 临床表现,该患者因 B 症状、肝脾肿大和双系细胞减少症入院检查。基于这些发现,怀疑为急性白血病。骨髓形态学免疫组化和流式细胞术有助于确定髓性 PBL 的诊断。由于感染性休克,患者病情恶化并死亡。这种病理需要临床医生、病理学家和生物学家之间的合作,以便及早确认诊断。然而,由于晚期咨询,延迟诊断可能会导致预后恶化,特别是由于晚期咨询。我们报告的病例说明了一种罕见的影响骨髓的临床表现。在我们的情况下,流式细胞术和免疫组化之间的对抗很有意义,因为它有助于检测这种肿瘤的免疫特征。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5fb9/10589407/61a6a5a2ab59/PAMJ-45-158-g001.jpg

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