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儿童和青少年复发性/耐火性侵略性B细胞淋巴瘤与t(8;14) 和BCL2表达,伯基特淋巴瘤与扩散性大B细胞淋巴瘤相比:一个诊断挑战

Fouad El Dana¹, Sofia Alexandra Garces Narvaez², Nader K El-Mallawany³

¹Department of Pathology & Immunology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.

Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society

|March 12, 2024

概括

在青少年中诊断复发性/耐药性侵袭性B细胞淋巴瘤是具有挑战性的. 目前的分类有助于诊断,但这些复杂的病例仍然存在治疗困境.

科学领域:

血液学血液学血液学
在瘤学瘤学.
病理学病理学病理学

背景情况:

复发性/耐药性攻击性成熟B细胞非霍奇金淋巴瘤 (B-NHL) 存在诊断和治疗方面的挑战,特别是在儿科和青少年群体中.
病例属于伯基特淋巴瘤和扩散性大B细胞淋巴瘤的频谱,需要细微分类.
青少年和年轻人 (AYA) 面临着独特的治疗困境.

研究的目的:

提出两个诊断上具有挑战性的儿科/青少年复发性/耐药性侵袭性成熟B细胞非霍奇金淋巴瘤 (B-NHL) 的病例.
为了说明儿科和成人癌症中心用于这些具有挑战性的病例的治疗方案.
要突出在AYA患者中遇到的诊断挑战和治疗困境.

主要方法:

淋巴瘤细胞的详细形态和免疫类型分析.
细胞遗传学分析包括光在位杂交 (FISH) 为IGH::MYC重新排列.
基因突变的下一代测序 (NGS),包括TP53和MYC.

主要成果:

这两种病例都表现出异质淋巴瘤细胞,BCL2表达有所变化.
确定了复杂的型,具有t(8:14)(q24.2;q32) 和IGH::MYC重排.
通过NGS检测到有害的TP53和MYC突变.

结论:

根据2022年ICC和WHO-HAEM5分类,这些病例可以被诊断为"DLBCL-NOS与MYC重组".
该研究强调了这些淋巴瘤的AYA患者的诊断困难和治疗考虑.
有效的管理需要仔细的病理分类和量身定制的治疗策略.

关键词:

在B-NHL中.在BCL2中,BCL2是伯基特 (Burkitt) 是一个小鸟.DLBCL DLBCL 是一个字.国际刑事法庭国际刑事法庭国际刑事法庭国际刑事法庭世界卫生组织-HAEM5 侵袭性B细胞非霍奇金淋巴瘤儿科儿科儿科

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