Primary gastric Hodgkin's lymphoma expressing a B-cell profile including Oct-2 and Bob-1 proteins
Primary gastric Hodgkin's lymphoma expressing a B-cell profile including Oct-2 and Bob-1 proteins
复制标题
DOI：
10.1532/ijh97.06094
复制
发表时间：
2007-06-01
影响因子：
2.1
通讯作者：
Morioka, Masanobu
中科院分区：
文献类型：
--
作者：
Saito, Makoto;Tanaka, Shinya;Morioka, Masanobu
经典型霍奇金淋巴瘤（cHL）最常累及淋巴结，胃受累罕见。已知cHL中的霍奇金和Reed-Sternberg（H-RS）细胞通常缺乏几种B系标志物的表达，如CD 20、CD 79 a、Oct-2和Bob-1。我们提出了一个非常罕见的情况下，混合细胞型cHL在胃中，这些B细胞的表达被检测到免疫化学。患者是一名83岁的日本女性，出现腹部饱胀感和食欲不振。内镜和腹部计算机断层扫描检查分别显示胃溃疡病变和主动脉旁淋巴结肿胀。行胃大部切除术，组织病理学诊断确定为与胃起源相符的典型cHL。患者接受了3个周期ABVD（多柔比星、博莱霉素、长春碱和达卡巴嗪）的术后化疗，此后完全缓解。免疫组化显示，cHL中的H-RS细胞不仅CD 30阳性，而且CD 20、CD 79 a、Oct-2和Bob-1阳性，而CD 3、CD 15、CD 45、EMA和ALK 1阴性。我们的患者可能患有与非霍奇金外周B细胞淋巴瘤重叠的中间型cHL疾病，可能反映了起源于生殖中心B细胞。
Classic Hodgkin's lymphoma (cHL) most often involves lymph nodes, and gastric involvement is rare. Hodgkin's and Reed-Sternberg (H-RS) cells in cHL are known to often lack expression of several B-lineage markers, such as CD20, CD79a, Oct-2, and Bob-1. We present an extremely rare case of mixed-cellularity cHL in the stomach in which expression of these B-cells was detected immunohistochemically. The patient was an 83-year-old Japanese woman who developed a sensation of abdominal fullness and appetite loss. Endoscopic and abdominal computed tomography examinations revealed a gastric ulcer lesion and swelling of para-aortic lymph nodes, respectively. A subtotal gastrectomy was performed, and the histopathologic diagnosis was established as a typical cHL compatible with stomach origin. The patient underwent postoperative chemotherapy of 3 cycles of ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) and has since been in complete remission. Immunohistochemically, the H-RS cells in the cHL were positive not only for CD30 but also for CD20, CD79a, Oct-2, and Bob-1, whereas they were negative for CD3, CD15, CD45, EMA, and ALK1. Our patient may have had an intermediate cHL disease overlapping that of non-Hodgkin's peripheral B-cell lymphoma, possibly reflecting derivation from germinal-center B-cells.