三重打击的TdT阳性高等级B细胞淋巴瘤模仿B淋巴细胞淋巴瘤,并在复发时表现出免疫表型变化
Akio Saito1, Atsushi Isoda1,2, Yukie Terasaki1
1Department of Hematology, NHO Shibukawa Medical Center, Shibukawa, Gunma, Japan.
Journal of clinical and experimental hematopathology : JCEH
|October 29, 2025
概括
本案例研究详细介绍了一种罕见的侵袭性淋巴瘤,最初模仿B型淋巴细胞淋巴瘤. 瘤在复发时表现出显著的免疫表型变化,突出显示了对高级B细胞淋巴瘤进行综合分析的必要性.
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:
- 高度B细胞淋巴瘤 (HGBCL) 具有MYC和BCL2/BCL6重组 (
- 双 / 三重击中 - 双 / 三重击中
- 淋巴瘤) 是积极的,可以模仿B-淋巴细胞淋巴瘤 (B-LBL).
- 由于不同的治疗策略,准确的诊断至关重要.
研究的目的:
- 报告一个罕见的TdT阳性HGBCL病例与三重重排.
- 要突出在复发时观察到的显著免疫表型变化.
- 强调全面的诊断分析的重要性.
主要方法:
- 一个63岁的女性患有十二指肠HGBCL的病例报告.
- 免疫类型 (流细胞计) 和光 in situ 杂交 (FISH) 用于基因分析.
- 在诊断和复发时对瘤活检的分析.
主要成果:
- 最初的诊断:TdT +,CD10 +,CD20-,BCL6-,CD45dim,MYC,BCL2,BCL6的重新安排.
- 复发:瘤细胞显示TdT的损失,CD20的增加,BCL6表达的改变,而剩下的CD10+.
- 尽管接受了救援治疗,但患者还是死于这种疾病.
结论:
- 这是第一个报告的TdT阳性HGBCL病例,在复发时失去TdT表达.
- 在这种罕见的淋巴瘤亚型中,可以出现显著的表型可塑性.
- 在诊断和复发时进行全面的免疫类型和遗传评估对于准确的分类和管理至关重要.
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