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Significant response of patients with transformed follicular lymphoma with rapid disease progression to CAR-T therapy. 疾病进展迅速的转化性滤泡性淋巴瘤患者对CAR-T治疗的显著反应
IF 0.9 Q4 HEMATOLOGY Pub Date : 2023-12-26 Epub Date: 2023-11-30 DOI: 10.3960/jslrt.23033
Taichi Hirano, Hiro Tatetsu, Shikiko Ueno, Takafumi Shichijo, Shota Furukawa, Mizuho Tsujihashi, Toshikazu Miyakawa, Shinya Shiraishi, Yusuke Higuchi, Mitsuhiro Uchiba, Jun-Ichirou Yasunaga, Kisato Nosaka, Masao Matsuoka
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引用次数: 0
RUNX1 rearrangement in mature B-cell acute lymphoblastic leukemia with non-L3 morphology. RUNX1重排在具有非L3形态的成熟B细胞急性淋巴细胞白血病中的表达。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-12-26 Epub Date: 2023-10-28 DOI: 10.3960/jslrt.23028
Katsuya Yamamoto, Akihito Kitao, Marika Watanabe, Hiroshi Kanehira, Miki Joyce, Yuri Hirakawa, Sakuya Matsumoto, Kimikazu Yakushijin, Hironobu Minami

Mature B-cell acute lymphoblastic leukemia (ALL) is defined by the expression of light chain-restricted surface immunoglobulin (sIg) and usually has features of the leukemic phase of Burkitt lymphoma including FAB-L3 morphology and MYC rearrangement. Recently, another distinct entity in childhood mature B-cell ALL has been characterized as non-L3 morphology and KMT2A rearrangement. Here we report an unusual case of mature B-cell ALL that presented with RUNX1 rearrangement. A 65-year-old male was admitted to our department for thorough examination of leukocytosis and thrombocytopenia. The patient's bone marrow was hypercellular and infiltrated with 97.8% myeloperoxidase-negative, medium-to-large-sized blasts without cytoplasmic vacuoles. Immunophenotypes were characterized by the presence of light chain-restricted sIg and the lack of immature markers, indicating a diagnosis of mature B-cell ALL with L2 morphology: sIg-κ+, CD19+, CD20+, CD22+, CD79a+, TdT-, and CD34-. G-banding combined with spectral karyotyping showed the following complex karyotype: 45,X,der(Y;10)(p10;q10),del(13)(q?),inv(21)(p13q22.1). Fluorescence in situ hybridization revealed separated signals of RUNX1 at 21q22.1, whereas rearrangements of MYC and KMT2A were not found. To our knowledge, inv(21)(p13q22.1) involving RUNX1 is a novel cytogenetic aberration and this is the first case of mature B-cell ALL that presented with RUNX1 rearrangement. Thus, RUNX1 may be implicated in the pathogenesis of mature B-cell ALL showing non-L3 morphology without MYC rearrangement.

成熟B细胞急性淋巴细胞白血病(ALL)是由轻链限制性表面免疫球蛋白(sIg)的表达定义的,通常具有伯基特淋巴瘤白血病期的特征,包括FAB-L3形态和MYC重排。最近,儿童成熟B细胞ALL中的另一个独特实体被表征为非L3形态和KMT2A重排。在这里,我们报告了一例不寻常的成熟B细胞ALL,表现为RUNX1重排。一名65岁男性因白细胞增多症和血小板减少症入院接受全面检查。患者的骨髓细胞增生,骨髓中有97.8%的髓过氧化物酶阴性、中等至大尺寸的成纤维细胞浸润,没有细胞质液泡。免疫表型的特征是存在轻链限制性sIg和缺乏未成熟标志物,表明诊断为具有L2形态的成熟B细胞ALL:sIg-κ+、CD19+、CD20+、CD22+、CD79a+、TdT-和CD34-。G显带结合光谱核型分析显示如下复杂核型:45,X,der(Y;10)(p10;q10),del(13)(q?),inv(21)(p13q22.1)。荧光原位杂交显示RUNX1在21q22.1处分离信号,而MYC和KMT2A没有重排。据我们所知,涉及RUNX1的inv(21)(p13q22.1)是一种新的细胞遗传学畸变,这是第一例出现RUNX1重排的成熟B细胞ALL。因此,RUNX1可能与显示无MYC重排的非L3形态的成熟B细胞ALL的发病机制有关。
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引用次数: 0
A case of classic Hodgkin lymphoma arising after remission of methotrexate-associated follicular lymphoma. 甲氨蝶呤相关滤泡性淋巴瘤缓解后发生的典型霍奇金淋巴瘤一例。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23016
Yayoi Ueda, Takehiro Tanaka, Shoji Asakura, Tomofumi Yano

Here we describe our experience with a rare case of methotrexate (MTX)-associated lymphoproliferative disorder (LPD) initially diagnosed as follicular lymphoma (FL) and then in relapse as classic Hodgkin lymphoma (CHL). A 66-year-old man was admitted to the hospital with fever and abdominal and lower back pain after a transient remission of MTX-associated FL (MTX-FL) following MTX withdrawal. Computed tomography (CT) showed para-aortic lymphadenopathy, which was compatible with one of the previous FL lesions. We considered a relapse of FL and started bendamustine and rituximab. Although his initial symptoms and para-aortic lymphadenopathy regressed after the first course, he began to have dorsal pain, and multiple osteolytic lesions were detected on CT. We biopsied a Th4 vertebra osteolytic lesion, and the results indicated MTX-associated CHL (MTX-CHL). We successfully treated advanced MTX-CHL with brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD). This case suggests the importance of repeat biopsy of a new lesion arising after resolution of previously affected sites in MTX-LPD and the effectiveness of A+AVD in treating advanced MTX-CHL.

在这里,我们描述了一例罕见的甲氨蝶呤(MTX)相关淋巴增生性疾病(LPD)的经验,最初诊断为滤泡性淋巴瘤(FL),然后复发为经典霍奇金淋巴瘤(CHL)。一名66岁的男性因停药后MTX相关FL(MTX-FL)暂时缓解而发烧、腹部和下背部疼痛入院。计算机断层扫描(CT)显示主动脉旁淋巴结病,与之前的FL病变一致。我们考虑到FL复发,开始使用本达莫司汀和利妥昔单抗。尽管他的最初症状和主动脉旁淋巴结病在第一个疗程后消退,但他开始出现背部疼痛,CT上检测到多处溶骨性病变。我们对一处Th4脊椎溶骨性病变进行了活检,结果显示MTX相关CHL(MTX-CHL)。我们用布伦妥昔单抗韦多汀、阿霉素、长春碱和达卡巴嗪(A+AVD)成功治疗晚期MTX-CHL。该病例表明,对MTX-LPD中先前受影响部位消退后出现的新病变进行重复活检的重要性,以及a+AVD治疗晚期MTX-CHL的有效性。
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引用次数: 0
Infections associated with bendamustine and anti-CD20 antibody in untreated follicular lymphoma: a real-world study. 未经治疗的滤泡性淋巴瘤中与bendamustine和抗CD20抗体相关的感染:一项真实世界的研究。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23015
Masuho Saburi, Kazuki Okuhiro, Natsumi Yoshida, Takami Haruyama, Yui Moroga, Yuka Yanai, Kazuhito Itani, Kuniko Takano, Shuhei Honda, Keiji Ono, Manami Iwanaga, Hitohiro Sasaki, Miyuki Abe, Kazuhiro Kohno, Toshiyuki Nakayama, Eiichi Ohtsuka, Masao Ogata
), and PFS were compared between the BR and GB groups. Tumor volume was determined according to the Groupe d’Étude des Lymphomes Folliculaires (GELF) criteria, and response was determined according to the International Workshop to standardize response criteria for NHL, 9 using computed tomography (CT) or 18 F-fluorodeoxyglucose positron emission tomography/CT (FDG-PET/CT). Adverse events including febrile neutropenia, sepsis, pneumonia, herpes zoster, and cytomegalovirus (CMV) infection, were evaluated by CTCAE Ver5.0. Survival was analyzed starting from the date of treatment initiation. PFS was defined as the period from treatment to dis - ease progression, relapse, or death. The cumulative incidence of CMV infection was analyzed using Gray’s test, and the competing events were deaths due to causes other than infection. All statistical analyses were performed with EZR software. 10 This study was approved by the ethics review board of Oita Prefectural Hospital, and by the ethics review board of each collaborating research institution. Patients’ informed consent was obtained in the form of opt-out on a
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引用次数: 0
Follicular lymphoma microenvironment: insights provided by single-cell analysis. 毛囊淋巴瘤微环境:单细胞分析提供的见解。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-08-28 DOI: 10.3960/jslrt.23012
Yoshiaki Abe

Follicular lymphoma (FL) is the most frequent indolent lymphoma and is characterized by the abundant infiltration of tumor microenvironment (TME) cells. The activity of TME cells reportedly plays an important role in the biology of FL. TME cells that reside within neoplastic follicles, such as T-follicular helper cells and follicular dendritic cells, have been shown to aid in FL development and progression through interactions with malignant B cells, whereas regulatory T cells have unexpectedly shown an apparently favorable prognostic impact in FL. Unfortunately, the understanding of the FL TME, particularly regarding minor cell subsets, has been hampered by unknown cell heterogeneity. As with other solid and hematologic cancers, novel single-cell analysis technologies have recently been applied to FL research and have uncovered previously unrecognized heterogeneities, not only in malignant B cells but also in TME cells. These reports have greatly increased the resolution of our understanding of the FL TME and, at the same time, raised questions about newly identified TME cells. This review provides an overview of the unique aspects of FL TME cells with a clinical viewpoint and highlights recent discoveries from single-cell analysis, while also suggesting potential future directions.

滤泡性淋巴瘤(FL)是最常见的惰性淋巴瘤,其特征是肿瘤微环境(TME)细胞大量浸润。据报道,TME细胞的活性在FL的生物学中起着重要作用。位于肿瘤卵泡内的TME细胞,如T卵泡辅助细胞和卵泡树突状细胞,已被证明通过与恶性B细胞的相互作用来帮助FL的发育和进展,而调节性T细胞在FL中出人意料地显示出明显有利的预后影响。不幸的是,对FL TME的理解,特别是对小细胞亚群的理解,受到未知细胞异质性的阻碍。与其他实体癌和血液学癌症一样,新的单细胞分析技术最近被应用于FL研究,并发现了以前未被识别的异质性,不仅在恶性B细胞中,而且在TME细胞中。这些报告大大提高了我们对FL TME的理解,同时也提出了对新鉴定的TME细胞的质疑。这篇综述从临床角度概述了FL TME细胞的独特方面,并强调了单细胞分析的最新发现,同时也提出了潜在的未来方向。
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引用次数: 0
The pathobiology of follicular lymphoma. 滤泡性淋巴瘤的病理生物学。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23014
Joaquim Carreras

Follicular lymphoma is one of the most frequent lymphomas. Histologically, it is characterized by a follicular (nodular) growth pattern of centrocytes and centroblasts; mixed with variable immune microenvironment cells. Clinically, it is characterized by diffuse lymphadenopathy, bone marrow involvement, and splenomegaly. It is biologically and clinically heterogeneous. In most patients it is indolent, but others have a more aggressive evolution with relapses; and transformation to diffuse large B-cell lymphoma. Tumorigenesis includes an asymptomatic preclinical phase in which premalignant B-lymphocytes with the t(14;18) chromosomal translocation acquire additional genetic alterations in the germinal centers, and clonal evolution occurs, although not all the cells progress to the tumor stage. This manuscript reviews the pathobiology and clinicopathological characteristics of follicular lymphoma. It includes a description of the physiology of the germinal center, the genetic alterations of BCL2 and BCL6, the mutational profile, the immune checkpoint, precision medicine, and highlights in the lymphoma classification. In addition, a comment and review on artificial intelligence and machine (deep) learning are made.

滤泡性淋巴瘤是最常见的淋巴瘤之一。在组织学上,其特征是中心细胞和成中心细胞的滤泡(结节)生长模式;与可变免疫微环境细胞混合。临床表现为弥漫性淋巴结病、骨髓受累和脾肿大。它具有生物学和临床异质性。在大多数患者中,它是惰性的,但其他患者随着复发而有更积极的演变;以及转化为弥漫性大B细胞淋巴瘤。肿瘤发生包括无症状的临床前阶段,在该阶段,具有t(14;18)染色体易位的癌前B淋巴细胞在生发中心获得额外的遗传改变,并发生克隆进化,尽管并非所有细胞都进展到肿瘤阶段。本文综述了滤泡性淋巴瘤的病理生物学和临床病理特征。它包括对生发中心的生理学、BCL2和BCL6的遗传改变、突变谱、免疫检查点、精准医学以及淋巴瘤分类的亮点的描述。此外,还对人工智能和机器(深度)学习进行了评述。
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引用次数: 0
Acalabrutinib and steroid for autoimmune thrombocytopenia due to relapsed chronic lymphocytic leukemia with severe bone marrow infiltration. Acalabrutinib和类固醇治疗复发性慢性淋巴细胞白血病伴严重骨髓浸润引起的自身免疫性血小板减少症。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-08-28 DOI: 10.3960/jslrt.23023
Takashi Oyama, Megumi Yasunaga, Masahiro Jona, Masako Nishikawa, Yutaka Yatomi, Akira Honda, Hiroaki Maki, Ken Morita, Yosuke Masamoto, Mineo Kurokawa

Thrombocytopenia is a frequent complication in chronic lymphocytic leukemia (CLL). Differentiating autoimmune thrombocytopenia from thrombocytopenia due to bone marrow infiltration is necessary for appropriate treatment, but sometimes difficult. Here we report a 60-year-old male patient with CLL who had achieved complete response after treatment with fludarabine, cyclophosphamide, and rituximab two years prior to presentation. He was admitted with severe thrombocytopenia that was unresponsive to intravenous immunoglobulin. Imaging studies revealed systemic enlarged lymph nodes and bone marrow aspiration was hypercellular with > 95% lymphocytes and scant megakaryocytes. Acalabrutinib 200 mg/day was administered for the treatment of CLL exacerbation. A gradual decrease in CLL cells and recovery of megakaryocytes in bone marrow were observed, but platelet counts remained low. Systemic administration of prednisolone 0.5 mg/kg, in addition to acalabrutinib, was started, considering the contribution of autoimmune thrombocytopenia; platelet recovery was rapid and sustained for more than a year. Even if bone marrow examination suggested thrombocytopenia due to direct leukemic infiltration, it is difficult to exclude the possibility of concomitant immunogenic thrombocytopenia. We conclude that for CLL patients with severe thrombocytopenia, repeating bone marrow examination and concurrent immunosuppressive therapies and treatment of the underlying CLL may be beneficial.

血小板减少是慢性淋巴细胞白血病(CLL)的常见并发症。区分自身免疫性血小板减少症和骨髓浸润引起的血小板减少症对于适当的治疗是必要的,但有时很困难。在此,我们报告了一名60岁的CLL男性患者,他在就诊前两年接受氟达拉滨、环磷酰胺和利妥昔单抗治疗后获得了完全缓解。他因严重血小板减少症入院,对静脉注射免疫球蛋白无反应。影像学研究显示,全身肿大的淋巴结和骨髓抽吸是高细胞的,淋巴细胞>95%,缺乏巨核细胞。Acalabrutinib 200mg/天用于CLL恶化的治疗。观察到骨髓中CLL细胞逐渐减少,巨核细胞恢复,但血小板计数仍然很低。考虑到自身免疫性血小板减少症的影响,开始全身给药泼尼松龙0.5 mg/kg和阿克拉布替尼;血小板恢复迅速并持续了一年多。即使骨髓检查提示白血病直接浸润导致血小板减少,也很难排除伴随免疫原性血小板减少的可能性。我们的结论是,对于患有严重血小板减少症的CLL患者,重复骨髓检查、同时进行免疫抑制治疗和潜在CLL的治疗可能是有益的。
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引用次数: 0
Kikuchi-Fujimoto disease following COVID-19 in a 32-year-old woman. 新冠肺炎后一名32岁女性患Kikuchi-Fujimoto病。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23022
Rin Yamada, Yoshihiro Komohara, Hiroshi Yoshii
not associated with COVID-19, with the exception of three cases showing uncommon complications, including heart involvement, generalized lymphade-nopathies, and multisystem inflammatory syndrome. 7,8,10 All but two cases showed complete resolution of clinical symptoms. In one case, cardiac function remained reduced, although whether the heart involvement was associated with KFD or COVID-19 remained unclear. 7 In another case, the clinical course was not documented. 12 Viral particles have never been identified ultrastructurally in the lymph nodes of patients with KFD. The present case and a previous case also did not demonstrate SARS-CoV-2 immunohistochemically. 5 Differential diagnoses for patients with cervical lymph-adenopathy following COVID-19 should include KFD to avoid unnecessary therapeutic interventions, particularly in patients under 40 years old. Further study regarding the relationship between KFD and COVID-19 is necessary.
{"title":"Kikuchi-Fujimoto disease following COVID-19 in a 32-year-old woman.","authors":"Rin Yamada, Yoshihiro Komohara, Hiroshi Yoshii","doi":"10.3960/jslrt.23022","DOIUrl":"10.3960/jslrt.23022","url":null,"abstract":"not associated with COVID-19, with the exception of three cases showing uncommon complications, including heart involvement, generalized lymphade-nopathies, and multisystem inflammatory syndrome. 7,8,10 All but two cases showed complete resolution of clinical symptoms. In one case, cardiac function remained reduced, although whether the heart involvement was associated with KFD or COVID-19 remained unclear. 7 In another case, the clinical course was not documented. 12 Viral particles have never been identified ultrastructurally in the lymph nodes of patients with KFD. The present case and a previous case also did not demonstrate SARS-CoV-2 immunohistochemically. 5 Differential diagnoses for patients with cervical lymph-adenopathy following COVID-19 should include KFD to avoid unnecessary therapeutic interventions, particularly in patients under 40 years old. Further study regarding the relationship between KFD and COVID-19 is necessary.","PeriodicalId":45936,"journal":{"name":"Journal of Clinical and Experimental Hematopathology","volume":" ","pages":"209-211"},"PeriodicalIF":1.5,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Poor clinical outcome of relapsed/refractory diffuse large B-cell lymphoma with MYC translocation treated with polatuzumab vedotin, bendamustine, and rituximab. 波拉图珠单抗-韦多汀、本达莫司汀和利妥昔单抗治疗复发/难治性弥漫性大B细胞淋巴瘤伴MYC易位的不良临床结果。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23017
Masuho Saburi, Masanori Sakata, Yousuke Kodama, Keiichi Uraisami, Hiroyuki Takata, Yasuhiko Miyazaki, Junpei Wada, Shogo Urabe, Eiichi Ohtsuka
{"title":"Poor clinical outcome of relapsed/refractory diffuse large B-cell lymphoma with MYC translocation treated with polatuzumab vedotin, bendamustine, and rituximab.","authors":"Masuho Saburi, Masanori Sakata, Yousuke Kodama, Keiichi Uraisami, Hiroyuki Takata, Yasuhiko Miyazaki, Junpei Wada, Shogo Urabe, Eiichi Ohtsuka","doi":"10.3960/jslrt.23017","DOIUrl":"10.3960/jslrt.23017","url":null,"abstract":"","PeriodicalId":45936,"journal":{"name":"Journal of Clinical and Experimental Hematopathology","volume":" ","pages":"201-204"},"PeriodicalIF":1.5,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9897792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Diffuse large B-cell lymphoma with composite germinal center and non-germinal center types: A report of two cases. 具有复合生发中心和非生发中心类型的弥漫性大B细胞淋巴瘤:附2例报告。
IF 1.5 Q4 HEMATOLOGY Pub Date : 2023-09-28 Epub Date: 2023-07-28 DOI: 10.3960/jslrt.23020
Ayumi Sugitani, Suguru Fukuhara, Maki Shibata, Ryosuke Ichihara, Haruhi Furukawa, Akiko Miyagi Maeshima

We report two cases of diffuse large B-cell lymphoma (DLBCL) with composite germinal center B-cell (GCB) and non-GCB types. Case 1 was a 72-year-old woman with inguinal lymph node swelling. Two morphologically different lesions were concurrently observed in needle biopsy specimens. One lesion was DLBCL with centroblastic morphology and a GCB phenotype (CD10+, BCL6+, and MUM1-), according to the Hans algorithm. The other lesion was DLBCL with anaplastic morphology and a non-GCB phenotype (CD10-, BCL6+, and MUM1+). Considering cellular atypia, the GCB-type DLBCL likely progressed to non-GCB-type DLBCL. Case 2 was a 34-year-old man who underwent ileocecal resection, with four lesions observed in the ileum. All four lesions indicated centroblastic morphology. Three lesions showed a GCB phenotype (CD10+, BCL6+, and MUM1+), while the other showed a non-GCB phenotype (CD10-, BCL6+, and MUM1+). These tumors were clonally related. BCL2 expression and MYC rearrangement were not related to changes in the cell of origin (COO) in either case. In conclusion, changes in the COO in DLBCL may not be uncommon. Therefore, investigation of the COO in other sites or at relapse may be needed if new drugs with different indications for each COO are developed.

我们报告了两例弥漫性大B细胞淋巴瘤(DLBCL),具有复合生发中心B细胞(GCB)和非GCB型。病例1为72岁女性,腹股沟淋巴结肿大。在针活检标本中同时观察到两种形态不同的病变。根据Hans算法,一种病变为DLBCL,具有成中心细胞形态和GCB表型(CD10+、BCL6+和MUM1-)。另一种病变是DLBCL,具有间变性形态和非GCB表型(CD10-、BCL6+和MUM1+)。考虑到细胞异型性,GCB型DLBCL可能发展为非GCB型。病例2是一名34岁的男性,他接受了回盲部切除术,在回肠中观察到四处病变。所有四个病变均显示中心母细胞形态。三个病变显示GCB表型(CD10+、BCL6+和MUM1+),而另一个病变显示非GCB表型。这些肿瘤具有克隆相关性。BCL2表达和MYC重排与来源细胞(COO)的变化均无关。总之,DLBCL中COO的变化可能并不罕见。因此,如果开发出针对每个COO具有不同适应症的新药,则可能需要对其他部位或复发时的COO进行调查。
{"title":"Diffuse large B-cell lymphoma with composite germinal center and non-germinal center types: A report of two cases.","authors":"Ayumi Sugitani, Suguru Fukuhara, Maki Shibata, Ryosuke Ichihara, Haruhi Furukawa, Akiko Miyagi Maeshima","doi":"10.3960/jslrt.23020","DOIUrl":"10.3960/jslrt.23020","url":null,"abstract":"<p><p>We report two cases of diffuse large B-cell lymphoma (DLBCL) with composite germinal center B-cell (GCB) and non-GCB types. Case 1 was a 72-year-old woman with inguinal lymph node swelling. Two morphologically different lesions were concurrently observed in needle biopsy specimens. One lesion was DLBCL with centroblastic morphology and a GCB phenotype (CD10<sup>+</sup>, BCL6<sup>+</sup>, and MUM1<sup>-</sup>), according to the Hans algorithm. The other lesion was DLBCL with anaplastic morphology and a non-GCB phenotype (CD10<sup>-</sup>, BCL6<sup>+</sup>, and MUM1<sup>+</sup>). Considering cellular atypia, the GCB-type DLBCL likely progressed to non-GCB-type DLBCL. Case 2 was a 34-year-old man who underwent ileocecal resection, with four lesions observed in the ileum. All four lesions indicated centroblastic morphology. Three lesions showed a GCB phenotype (CD10<sup>+</sup>, BCL6<sup>+</sup>, and MUM1<sup>+</sup>), while the other showed a non-GCB phenotype (CD10<sup>-</sup>, BCL6<sup>+</sup>, and MUM1<sup>+</sup>). These tumors were clonally related. BCL2 expression and MYC rearrangement were not related to changes in the cell of origin (COO) in either case. In conclusion, changes in the COO in DLBCL may not be uncommon. Therefore, investigation of the COO in other sites or at relapse may be needed if new drugs with different indications for each COO are developed.</p>","PeriodicalId":45936,"journal":{"name":"Journal of Clinical and Experimental Hematopathology","volume":" ","pages":"181-186"},"PeriodicalIF":1.5,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9899816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Clinical and Experimental Hematopathology
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