Primary platelet-derived growth factor-producing, spindle-shaped diffuse large B-cell lymphoma of the skull: a case report and literature review.
Primary platelet-derived growth factor-producing, spindle-shaped diffuse large B-cell lymphoma of the skull: a case report and literature review.
复制标题
颅骨原发性产生血小板衍生生长因子的梭形弥漫性大 B 细胞淋巴瘤：病例报告和文献综述。
DOI：
--
复制
发表时间：
2014
影响因子：
1.4
通讯作者：
M. Noguchi
中科院分区：
文献类型：
--
作者：
K. Sugimoto;Asami Shimada;Kunimoto Ichikawa;M. Wakabayashi;Y. Sekiguchi;H. Izumi;Y. Ota;N. Komatsu;M. Noguchi
一名 39 岁的女性因右额叶肿块接受了颅骨肿瘤活检。苏木精和伊红染色玻片的组织病理学检查显示，梭形肿瘤细胞呈席纹状，看起来有点像肉瘤。然而，通过免疫组织化学染色，肿瘤细胞呈CD20阳性。因此，诊断为梭形弥漫性大B细胞淋巴瘤（Sp-DLBCL）。文献中至少记录了 35 例 Sp-DLBCL，大多数为生发中心型，而本病例是首例波形蛋白阳性的颅骨原发性 Sp-DLBCL 报告。由于成纤维细胞增殖的证据，对本例中的 DLBCL 进行了六种代表性细胞因子的免疫组织化学染色，这些细胞因子可能导致纤维化。 DLBCL细胞血小板衍生生长因子（PDGF）呈阳性，部分细胞还呈肿瘤坏死因子（TNF）α阳性。基于这些发现，推测DLBCL细胞产生的PDGF和TNFα诱导成纤维细胞增殖。由此产生的明显纤维化引起 DLBCL 细胞的纤维间撞击，使它们变形为纺锤形。本病例是首例报道的产生 PDGF 的 Sp-DLBCL 病例。
A 39-year-old woman with a right frontal mass underwent a cranial bone tumor biopsy. Histopathologic examination of hematoxylin and eosin-stained slides showed spindle-shaped tumor cells in a storiform pattern, appearing somewhat like a sarcoma. However, the tumor cells were CD20-positive by immunohistochemical staining. Therefore, a diagnosis of spindle-shaped diffuse large B-cell lymphoma (Sp-DLBCL) was made. There have been at least 35 cases of Sp-DLBCL documented in the literature, and most were of the germinal center type, while the present case is the first report of a vimentin-positive primary Sp-DLBCL of the skull. The DLBCL in this case was immunohistochemically stained for six representative cytokines that might give rise to fibrosis, due to the evidence of fibroblastic proliferation. The DLBCL cells were positive for platelet-derived growth factor (PDGF), and some cells were also positive for tumor necrosis factor (TNF) α. Based on these findings, it was inferred that the PDGF and TNFα produced by DLBCL cells induced fibroblastic proliferation. The resultant conspicuous fibrosis caused interfibrous impingement on the DLBCL cells, which deformed them into a spindle shape. The present case is the first reported case of a PDGF-producing Sp-DLBCL.