{"title":"Splenic marginal zone lymphoma with villous lymphocytes: report of one case and review of literature","authors":"Li He, Y. Bao, Hai-yan Wang, Yan Liang, Wei Wei","doi":"10.3760/CMA.J.CN115356-2018-1031-00301","DOIUrl":null,"url":null,"abstract":"目的 \n提高对脾边缘区淋巴瘤（SMZL）伴绒毛状淋巴细胞的认识。 \n \n \n方法 \n回顾分析湖北医药学院附属襄阳市第一人民医院收治的1例SMZL伴绒毛状淋巴细胞患者资料，并复习国内外相关文献。 \n \n \n结果 \n该患者巨脾，白细胞增多，外周血及骨髓见部分淋巴细胞毛刺样改变；免疫分型示异常B淋巴细胞占81.07%，CD11c、CD20、FMC7、CD22、cKappa、CD79b阳性，sIgD部分阳性，CD19、CD81、sIgM弱阳性；骨髓病淋巴细胞比例增高，形态成熟，网状纤维染色MF-1级，Annexin阴性，局灶可见CD20+细胞窦内浸润，MYD88基因检测阴性，染色体分析未见可分析分裂象，符合SMZL伴绒毛状淋巴细胞的诊断标准。给予利妥昔单抗治疗，白细胞计数降至正常，病情好转出院。随访2个月一般情况良好。 \n \n \n结论 \nSMZL伴绒毛状淋巴细胞较罕见，诊断应结合患者病史、临床表现、细胞形态、组织病理、免疫分型、基因检测综合分析，通过脾脏病理可确诊，治疗首选利妥昔单抗。","PeriodicalId":16246,"journal":{"name":"白血病·淋巴瘤","volume":"29 1","pages":"189-192"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"白血病·淋巴瘤","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/CMA.J.CN115356-2018-1031-00301","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Objective To improve the understanding of splenic marginal zone lymphoma (SMZL) with villous lymphocytes. Method: A retrospective analysis was conducted on the data of a patient with SMZL and villous lymphocytes admitted to the First People's Hospital of Xiangyang City, Affiliated to Hubei Medical College, and relevant literature at home and abroad was reviewed. The patient had a splenomegaly, increased white blood cells, and some lymphocytes with spicule like changes were observed in peripheral blood and bone marrow; Immunophenotyping showed abnormal B lymphocytes accounting for 81.07%, positive for CD11c, CD20, FMC7, CD22, cKappa, and CD79b, partially positive for sIgD, and weakly positive for CD19, CD81, and sIgM; The proportion of lymphocytes in bone marrow disease is increased, with mature morphology. Reticular fiber staining is MF-1 grade, and Annexin is negative. Focal infiltration of CD20+cells in the sinuses is visible, and MYD88 gene testing is negative. Chromosome analysis shows no analyzable mitosis, meeting the diagnostic criteria for SMZL with villous lymphocytes. Treatment with rituximab resulted in a decrease in white blood cell count to normal and improved condition before discharge. Follow up for 2 months generally shows good condition. Conclusion: SMZL with villous lymphocytes is rare, and the diagnosis should be based on a comprehensive analysis of the patient's medical history, clinical manifestations, cell morphology, histopathology, immune typing, and gene testing. The diagnosis can be made through spleen pathology, and rituximab is the preferred treatment.
期刊介绍：
The JLL is a specialized academic journal that carries articles on hematological malignancies, and mainly about leukemia and lymphoma, involving the fields of medicine, chemistry, biology, etc. The purposes are to reflect the scientific results and the academic trends in the hematological malignancy field. It paid attention on both the basic research and clinical work, but more on the clinical side; on combining popularization with the raising of standards, but more on the raising of standards, in order to provide a field for exchanging experience, inspiring mutually and linking up information for those working for the basic research and clinical diagnosis and treatment in the field of leukemia and lymphoma. It is intended for high and middle ranking medical staffs.
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