CAJ | 학술논문

目的探讨ALK阳性大B细胞淋巴瘤的临床病理特点.方法回顾性分析1例ALK阳性大B细胞淋巴瘤患者的临床资料、组织病理学特征、免疫表型及荧光原位杂交(FISH)检测结果,并结合文献进行讨论.结果患者为30岁男性,左颈淋巴结肿大.光学显微镜下观察淋巴结内瘤细胞呈片巢状,核圆而淡染,中位大核仁,胞质丰富,嗜双色性,呈免疫母细胞或浆母细胞分化特点.免疫组织化学结果示肿瘤细胞CD138+、ALK+、CD45RO+、CD4+、Perforin+、CD117+、Kappa+、CD3-、CD20-、CD30-、CD38-、CD79a-、EMA-.FISH检测发现存在ALK基因的易位.患者手术后行CHOP方案化疗4个周期,4个月后病情进展,仍在继续接受治疗.结论 ALK阳性大B细胞淋巴瘤是弥漫大B细胞淋巴瘤的罕见亚型,具有独特的形态学、免疫表型和分子遗传学特点.
목적 탐토ALK양성대B세포림파류적림상병리특점.방법 회고성분석1례ALK양성대B세포림파류환자적림상자료、조직병이학특정、면역표형급형광원위잡교(FISH)검측결과,병결합문헌진행토론.결과 환자위30세남성,좌경림파결종대.광학현미경하관찰림파결내류세포정편소상,핵원이담염,중위대핵인,포질봉부,기쌍색성,정면역모세포혹장모세포분화특점.면역조직화학결과시종류세포CD138+、ALK+、CD45RO+、CD4+、Perforin+、CD117+、Kappa+、CD3-、CD20-、CD30-、CD38-、CD79a-、EMA-.FISH검측발현존재ALK기인적역위.환자수술후행CHOP방안화료4개주기,4개월후병정진전,잉재계속접수치료.결론 ALK양성대B세포림파류시미만대B세포림파류적한견아형,구유독특적형태학、면역표형화분자유전학특점.
Objective To study clinicopathologic features of ALK-positive large B-cell lymphoma.Methods The clinical data,histopathological characteristics,immunophenotype and fluorescence in situ hybridization (FISH) result of a patient with ALK-positive large B-cell lymphoma were analyzed and discussed combined with related literatures.Results A 30-years-old male patients with the left neck lymphadenectasis was studied.Histological evaluation revealed the tumor grew in sheets in the nodal,with round nuclei,dispersed chromatin,a single prominent central nucleolus and moderate amounts of eosinophilic to amphophilic cytoplasm.The neoplastic cells exhibited immunoblastic/plasmablastic morphology.Immunohistochemistry measurement showed that the tumor cells were marked positively by CD138,ALK-1,CD45RO,CD4,Perforin,CD117 and Kappa proteins,while negatively by CD3,CD8,CD20,CD30,CD38,CD57,CD79a,Pax-5,EMA and AE1/AE3 proteins.FISH test demonstrated the presence of ALK gene translocation.The patient was given 4 cycles of CHOP chemotherapy after surgery.However,the conditions deteriorated after 4 months.Now the patient continued to receive treatment.Conclusion ALK-positive large B-cell lymphoma represents a distinct variant of diffuse large B-cell lymphoma,and the tumor has special histological features along with a distinct immunophenotype and ALK gene rearrangement.