HIV阴性浆母细胞性淋巴瘤2例临床病理分析

Human immunodeficiency virus-negative plasmablastic lymphoma:clinicopathological analysis in 2 cases

目的:探讨人免疫缺陷病毒(HIV)阴性的浆母细胞性淋巴瘤(PBL)临床病理特征。方法:收集2例HIV阴性PBL的临床病理资料,分析其病理形态学特征、免疫表型及分子改变,并复习相关文献。结果:2例患者均为女性,年龄分别为71岁、54岁。1例位于胃,1例位于淋巴结。镜下肿瘤细胞呈浆母细胞样或免疫母细胞样,可见核分裂象及星空现象。免疫表型均表达浆细胞标志物,Ki-67增殖指数高,EBER(-)。1例检出MYC基因易位,1例未检出MYC基因易位。结论:HIV阴性PBL是弥漫性大B细胞淋巴瘤的一种独立亚型,具有特征性的形态学及免疫表型,需与多种疾病进行鉴别。

Objective:To investigate the clinicopathological features of human immunodeficiency virus(HIV)-negative plasmablastic lymphoma(PBL).Methods:Clinicopathological data were obtained from two cases of HIV-negative PBL.The histological features,immunohistochemical phenotype and gene testing results were described,and relevant literatures were reviewed.Results:The two patients were females,aged 71 and 54 years,respectively.The tumor occurred in stomach in one case,and in lymphonode in another.Microscopic examination revealed that the tumor cells were in plasmablastic or immunoblastic fashion,with mitosis and astrocytosis.Immunohistochemically,the neoplastic cells were diffusely positive for plasma cell marker.Ki-67 proliferation index was high,and EBER was negative.Fluorescence in situ hybridization showed positive MYC in one case and negative in another.Conclusion:HIV-negative PBL is an independent subtype of diffuse large B-cell lymphoma,with characterized morphology and immunophenotype.Diagnosis of it requires differentiation from a variety of similar neoplasm.