BACKGROUND B-cell lymphoma,unclassifiable,with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma(BCLu-DLBCL/cHL),also referred to as gray zone lymphoma(GZL),is known to share f...BACKGROUND B-cell lymphoma,unclassifiable,with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma(BCLu-DLBCL/cHL),also referred to as gray zone lymphoma(GZL),is known to share features with cHL and DLBCL.However,GZL is often difficult to diagnose.There is no consensus regarding the optimal therapeutic regimen.Most reported cases of GZL have been in Caucasian and Hispanic individuals,and its incidence is lower in African-American and Asian populations,including the Japanese population.CASE SUMMARY A 69-year-old female presented at our hospital with a growing mass on the right side of her neck.An elastic,soft mass measuring 9 cm×6 cm was palpable in the right cervical region.Laboratory analyses showed pancytopenia,increased serum lactate dehydrogenase levels,and markedly increased levels of soluble interleukin-2 receptor.Enhanced computed tomography(CT)and fluorodeoxyglucose positron emission tomography(PET)/CT revealed multiple lesions throughout her body.She was diagnosed with GZL based on the characteristic pathological findings,the immunophenotype[CD20+,PAX5+,OCT2+/BOB1(focal+),CD30+,CD15-],and the strong positive expression of neoplastic programmed cell death protein ligand 1(PD-L1)in her lymphoma cells.The lymphoma was stage IV according to the Lugano classification and high-risk according to the International Prognostic Index for aggressive non-Hodgkin lymphoma.The patient received cyclophosphamide,doxorubicin,vincristine,prednisolone,and rituximab(R-CHOP)chemotherapy because the tumor cells were CD20+.She has remained in complete remission for 3 years.CONCLUSION GZL was diagnosed based on histopathology and immunophenotyping with ancillary PD-L1 positivity.R-CHOP chemotherapy was an effective treatment.展开更多
目的探讨灰区淋巴瘤(gray zone lymphoma,GZL)的临床病理特点及免疫表型特征。方法应用光镜观察、免疫组织化学检查对1例颈部GZL的病例进行临床病理学分析,并结合文献讨论。结果 1例颈部GZL的组织学形态提示结节硬化性经典型霍奇金淋巴...目的探讨灰区淋巴瘤(gray zone lymphoma,GZL)的临床病理特点及免疫表型特征。方法应用光镜观察、免疫组织化学检查对1例颈部GZL的病例进行临床病理学分析,并结合文献讨论。结果 1例颈部GZL的组织学形态提示结节硬化性经典型霍奇金淋巴瘤(nodular sclerosis classical Hodgkin’s lymphoma,NSCHL),CD30(+)、CD15散在(+)、LMP-1(+),但免疫表型显示弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的特点,CD20弥漫(+)、CD79a(+)、PAX-5(+)、Oct-2(+)。结论 GZL是一种过渡型的淋巴瘤,形态学和免疫表型介于DLBCL和NSCHL之间,不能明确归类为CHL或DLBCL。展开更多
文摘BACKGROUND B-cell lymphoma,unclassifiable,with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma(BCLu-DLBCL/cHL),also referred to as gray zone lymphoma(GZL),is known to share features with cHL and DLBCL.However,GZL is often difficult to diagnose.There is no consensus regarding the optimal therapeutic regimen.Most reported cases of GZL have been in Caucasian and Hispanic individuals,and its incidence is lower in African-American and Asian populations,including the Japanese population.CASE SUMMARY A 69-year-old female presented at our hospital with a growing mass on the right side of her neck.An elastic,soft mass measuring 9 cm×6 cm was palpable in the right cervical region.Laboratory analyses showed pancytopenia,increased serum lactate dehydrogenase levels,and markedly increased levels of soluble interleukin-2 receptor.Enhanced computed tomography(CT)and fluorodeoxyglucose positron emission tomography(PET)/CT revealed multiple lesions throughout her body.She was diagnosed with GZL based on the characteristic pathological findings,the immunophenotype[CD20+,PAX5+,OCT2+/BOB1(focal+),CD30+,CD15-],and the strong positive expression of neoplastic programmed cell death protein ligand 1(PD-L1)in her lymphoma cells.The lymphoma was stage IV according to the Lugano classification and high-risk according to the International Prognostic Index for aggressive non-Hodgkin lymphoma.The patient received cyclophosphamide,doxorubicin,vincristine,prednisolone,and rituximab(R-CHOP)chemotherapy because the tumor cells were CD20+.She has remained in complete remission for 3 years.CONCLUSION GZL was diagnosed based on histopathology and immunophenotyping with ancillary PD-L1 positivity.R-CHOP chemotherapy was an effective treatment.
文摘目的探讨灰区淋巴瘤(gray zone lymphoma,GZL)的临床病理特点及免疫表型特征。方法应用光镜观察、免疫组织化学检查对1例颈部GZL的病例进行临床病理学分析,并结合文献讨论。结果 1例颈部GZL的组织学形态提示结节硬化性经典型霍奇金淋巴瘤(nodular sclerosis classical Hodgkin’s lymphoma,NSCHL),CD30(+)、CD15散在(+)、LMP-1(+),但免疫表型显示弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的特点,CD20弥漫(+)、CD79a(+)、PAX-5(+)、Oct-2(+)。结论 GZL是一种过渡型的淋巴瘤,形态学和免疫表型介于DLBCL和NSCHL之间,不能明确归类为CHL或DLBCL。
