Shold Janna, Jukic Lea, Farrell Daniel, Cui Wei, Zhang Da
Department of Pathology and Laboratory Medicine University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, Kansas 66160, USA.
University of Zagreb School of Medicine, Zagreb, Croatia.
Case Rep Hematol. 2024 Jul 18;2024:4803071. doi: 10.1155/2024/4803071. eCollection 2024.
Most B cell lymphomas are positive for one or more B cell markers including CD19, CD20, CD79a, or PAX5. However, rare cases of mature B cell lymphoma not expressing any B cell markers have been characterized and recognized as distinct diagnostic entities by current classification guidelines, including plasmablastic lymphoma, primary effusion lymphoma, and ALK-positive large B cell lymphoma. We present a case of pan-B cell marker negative, EBV positive diffuse large B cell lymphoma that is positive for OCT2, BOB1, and clonal immunoglobulin gene rearrangement that does not meet diagnostic criteria for any B cell lymphoma by current 4 and 5 Ed beta version WHO Hematolymphoid Tumors classification. In challenging cases like the one presented, utilizing OCT2 and BOB1 immunohistochemical stains can assist in determining B cell lineage. The WHO tumor classification system should consider adding OCT2 and BOB1 as alternative B cell lineage markers into their corresponding categories.
大多数B细胞淋巴瘤对一种或多种B细胞标志物呈阳性，包括CD19、CD20、CD79a或PAX5。然而，目前的分类指南已将罕见的不表达任何B细胞标志物的成熟B细胞淋巴瘤病例进行了特征描述，并确认为不同的诊断实体，包括浆母细胞淋巴瘤、原发性渗出性淋巴瘤和ALK阳性大B细胞淋巴瘤。我们报告一例全B细胞标志物阴性、EBV阳性的弥漫性大B细胞淋巴瘤，该病例对OCT2、BOB1呈阳性，且存在克隆性免疫球蛋白基因重排，但不符合现行第4版和第5版WHO血液淋巴肿瘤分类中任何B细胞淋巴瘤的诊断标准。在像本文所呈现的具有挑战性的病例中，利用OCT2和BOB1免疫组化染色有助于确定B细胞谱系。WHO肿瘤分类系统应考虑将OCT2和BOB1作为替代B细胞谱系标志物添加到相应类别中。
