Double-Hit Diffuse Large B-Cell Lymphoma
Double-Hit Diffuse Large B-Cell Lymphoma
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DOI：
10.1200/jco.2012.43.5800
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发表时间：
2012-10-01
影响因子：
45.3
通讯作者：
Friedberg, Jonathan W.
中科院分区：
文献类型：
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作者：
Friedberg, Jonathan W.
一名72岁的健康妇女出现急性腹痛和体重减轻10磅。正电子发射断层扫描显示[F-18]氟脱氧葡萄糖亲合性肠系膜淋巴结病，有证据表明在3 x 3 cm淋巴结附近存在肠压迫。该淋巴结活检显示弥漫性大B细胞淋巴瘤（DLBCL），CD 10+，80%的恶性细胞Ki-67染色（图1A至1D）。BCL 2免疫染色呈阳性;未进行MYC免疫染色。荧光原位杂交揭示了t（14; 18）BCL 2易位的证据和不是t（8; 14）的MYC基因重排的证据（图2A和2B）。骨髓活检为阴性，血清乳酸脱氢酶极轻微升高。患者现转介给您，讨论IIa期DLBCL的预后和管理，国际预后指数评分为2，具有双重遗传特征。
A 72-year-old previously healthy woman presented with acute abdominal pain and a 10-lb weight loss. Positron emission tomography demonstrated [F-18]fluorodeoxyglucose-avid mesenteric lymphadenopathy, with evidence of bowel compression near a 3 x 3 cm lymph node. Biopsy of this node revealed diffuse large B-cell lymphoma (DLBCL), CD10+, with Ki-67 staining 80% of malignant cells (Figs 1A to 1D). BCL2 immunostaining was positive; MYC immunostaining was not performed. Fluorescent in situ hybridization revealed evidence of a t(14; 18) BCL2 translocation and evidence of an MYC gene rearrangement that was not t(8; 14) (Figs 2A and 2B). Bone marrow biopsy was negative, and serum lactate dehydrogenase was minimally elevated. The patient is now referred to you to discuss the prognosis and management of stage IIa DLBCL, International Prognostic Index score of 2, with double-hit genetic features.