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El linfoma de células B después de un curso indolente de más de 30 años con cambios inmunofenotipicos en cada
Shintaro Yamanaka1, Shinji Hasebe1, Tomomi Fujii2
1Cancer Center, Ehime University Hospital, Toon city, Japan.
European journal of case reports in internal medicine
|February 11, 2026
Resumen
El linfoma difuso de células B grandes (DLBCL) puede cambiar su subtipo con el tiempo, lo que afecta el tratamiento. Las biopsias repetidas son cruciales para el diagnóstico preciso y la terapia personalizada en los casos de recaída.
Área de la Ciencia:
- Hematología Hematología.
- Oncología Oncología.
- La determinación del fenotipo inmunológico.
Sus antecedentes:
- El linfoma difuso de células B grandes (DLBCL) es una neoplasia maligna heterogénea con subtipos distintos.
- La estabilidad de las características de la célula de origen (COO) en DLBCL durante el curso de la enfermedad extendida no se entiende bien.
- Los datos de pacientes a largo plazo son esenciales para comprender la evolución de la enfermedad.
Objetivo del estudio:
- Investigar el potencial para la evolución inmunofenotípica y molecular en DLBCL durante un período prolongado.
- Para determinar si el perfil celular de origen de la DLBCL permanece estático durante las recaídas y tratamientos repetidos.
- Para resaltar la importancia de reevaluar las características de la DLBCL en la recaída.
Principales métodos:
- Un estudio de caso de un solo paciente con un diagnóstico de DLBCL que abarca más de tres décadas (1988-2019).
- Se realizaron evaluaciones histopatológicas e inmunofenotípicas en serie a lo largo del curso de la enfermedad del paciente y múltiples recaídas.
- Se documentó la historia del tratamiento, incluidos varios regímenes de quimioterapia y terapias dirigidas.
Principales resultados:
- El paciente exhibió DLBCL con cambios inmunofenotipicos secuenciales de un centro germinal similar a las células B (GCB) a un patrón de células B activadas (ABC) / no GCB.
- La enfermedad evolucionó a una variante anaplásica de células B CD30 positivas en etapas posteriores.
- El paciente se sometió a múltiples líneas de tratamiento para recaídas sucesivas durante 31 años.
Conclusiones:
- El DLBCL puede experimentar una evolución inmunofenotipica y molecular gradual significativa a lo largo de décadas.
- El perfil de COO de DLBCL no es estático y puede cambiar durante el curso de la enfermedad.
- Las biopsias repetidas y la reevaluación exhaustiva son fundamentales para adaptar las estrategias de tratamiento al estado actual de la DLBCL recidivada.
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