|
易误诊为ALCL的CD30阳性DLBCL 1例并文献复习
|
Abstract:
目的:提高对CD30阳性的弥漫大B细胞淋巴瘤(DLBCL)的认识。方法:回顾性分析2022年4月陕西省人民医院收治1例免疫组织化学染色CD30弥漫表达的DLBCL患者的临床资料,并进行文献复习。结果:患者为76岁男性,于外院行超声检查提示颈部3、4区淋巴结肿大,并行颈部淋巴结穿刺活检,结合其组织形态学特点及免疫组织化学染色等诊断为CD30阳性的弥漫大B细胞淋巴瘤。予BV联合CHP方案化疗2疗程,CHOP联合来那度胺方案化疗6疗程,患者肿大淋巴结较前明显缩小,疗效评估接近完全缓解。结论:CD30弥漫阳性的DLBCL较为罕见,其免疫表型及组织学形态与经典型ALCL相似,应尽早行组织病理学检查,明确诊断,尽早治疗。
Objective: To enhance understanding of CD30-positive Diffuse Large B-Cell Lymphoma (DLBCL). Methods: A retrospective analysis was conducted on the clinical data of a patient with immuno-histochemically stained CD30-positive DLBCL, treated in April 2022 at the Shaanxi Provincial Peo-ple’s Hospital. This included a review of relevant literature. Results: The patient, a 76-year-old male, presented with enlarged lymph nodes in regions 3 and 4 of the neck, as identified by ultrasound examination in another hospital. A neck lymph node biopsy, combined with histomorphological characteristics and immunohistochemical staining, led to the diagnosis of CD30-positive DLBCL. The patient underwent two cycles of chemotherapy with the BV + CHP regimen and six cycles with the CHOP + Lenalidomide regimen. There was a significant reduction in the size of the enlarged lymph nodes, and the therapeutic effect was assessed as nearing complete remission. Conclusion: CD30-positive DLBCL is relatively rare, with an immunophenotype and histological morphology similar to classical Anaplastic Large Cell Lymphoma (ALCL). Early histopathological examination for definitive diagnosis and prompt treatment is recommended.
[1] | 王晓卿, 徐钢, 李娟, 等. 淋巴瘤589例构成分析[J]. 临床与实验病理学杂志, 2011, 27(12): 1356-1358.
https://doi.org/10.13315/j.cnki.cjcep.2011.12.011 |
[2] | Sabattini, E., Bacci, F., Sagramoso, C. and Pileri, S.A. (2010) WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues in 2008: An Overview. Pathologica, 102, 83-87. |
[3] | 李小秋. CD30在淋巴瘤中的表达及检测: 现状与挑战[J]. 中国癌症杂志, 2022, 32(6): 512-518.
https://doi.org/10.19401/j.cnki.1007-3639.2022.06.005 |
[4] | Hoffbrand, A., Catovsky, D., Tuddenham, E., et al. (2010) Appendix II: World Health Organization Classification of Tumours of the Haematopoietic and Lymphoid Tissues.
https://www.who.int/publications/i?publishingoffices=c09761c0-ab8e-4cfa-9744-99509c4d306b |
[5] | Falini, B., Pileri, S., Pizzolo, G., et al. (1995) CD30 (Ki-1) Molecule: A New Cytokine Receptor of the Tumor Necrosis Factor Re-ceptor Superfamily as a Tool for Diagnosis and Immunotherapy. Blood, 85, 1-14.
https://doi.org/10.1182/blood.V85.1.1.bloodjournal8511 |
[6] | Slack, G.W., Steidl, C., Sehn, L.H. and Gascoyne, R.D. (2014) CD30 Expression in de novo Diffuse Large B-Cell Lymphoma: A Population-Based Study from British Columbia. British Journal of Haematology, 167, 608-617.
https://doi.org/10.1111/bjh.13085 |
[7] | Hu, S., Xu-Monette, Z.Y., Balasubramanyam, A., et al. (2013) CD30 Ex-pression Defines a Novel Subgroup of Diffuse Large B-Cell Lymphoma with Favorable Prognosis and Distinct Gene Expression Signature: A Report from the International DLBCL Rituximab-CHOP Consortium Program Study. Blood, 121, 2715-2724.
https://doi.org/10.1182/blood-2012-10-461848 |
[8] | Muris, J.J., Meijer, C.J., Vos, W., et al. (2006) Immunohisto-chemical Profiling Based on Bcl-2, CD10 and MUM1 Expression Improves Risk Stratification in Patients with Primary Nodal Diffuse Large B Cell Lymphoma. The Journal of Pathology, 208, 714-723. https://doi.org/10.1002/path.1924 |
[9] | Lu, T.X., Gong, Q.X., Wang, L., et al. (2015) Immunohistochemical Algo-rithm Alone Is Not Enough for Predicting the Outcome of Patients with Diffuse Large B-Cell Lymphoma Treated with R-CHOP. Clinical and Experimental Pathology, 8, 275-286. |
[10] | Iqbal, J., Greiner, T.C., Patel, K., et al. (2007) Dis-tinctive Patterns of BCL6 Molecular Alterations and Their Functional Consequences in Different Subgroups of Diffuse Large B-Cell Lymphoma. Leukemia, 21, 2332-2343.
https://doi.org/10.1038/sj.leu.2404856 |
[11] | Davis, R.E., Brown, K.D., Siebenlist, U. and Staudt, L.M. (2001) Con-stitutive Nuclear Factor κB Activity Is Required for Survival of Activated B Cell-Like Diffuse Large B Cell Lymphoma Cells. Journal of Experimental Medicine, 194, 1861-1874. https://doi.org/10.1084/jem.194.12.1861 |
[12] | Hu, S., Xu-Monette, Z.Y., Tzankov, A., et al. (2013) MYC/BCL2 Protein Coexpression Contributes to the Inferior Survival of Activated B-Cell Subtype of Diffuse Large B-Cell Lymphoma and Demonstrates High-Risk Gene Expression Signatures: A Report from The International DLBCL Rituximab-CHOP Consortium Program. Blood, 121, 4021-4250. https://doi.org/10.1182/blood-2012-10-460063 |
[13] | 贡其星. CD30阳性弥漫大B细胞淋巴瘤的临床病理学研究[D]: [博士学位论文]. 南京: 南京医科大学, 2017. |
[14] | 陈燕坪, 倪慕兰, 柯龙凤, 等. 伴PAX5拷贝数增加的PAX5阳性间变性大细胞淋巴瘤临床病理特征[J]. 中华病理学杂志, 2022, 51(11): 1155-1157. https://doi.org/10.3760/cma.j.cn112151-20220722-00637 |
[15] | Aizawa, S., Nakano, H., Ishida, T., et al. (1997) Tumor Necrosis Factor Receptor-Associated Factor (TRAF) 5 and TRAF2 Are Involved in CD30-Mediated NFκB Ac-tivation. Journal of Biological Chemistry, 272, 2042-2045.
https://doi.org/10.1074/jbc.272.4.2042 |