Mantle cell lymphoma with a unique pattern of CD5 expression: a case report with review of the literatures.
Mantle cell lymphoma with a unique pattern of CD5 expression: a case report with review of the literatures.
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具有独特 CD5 表达模式的套细胞淋巴瘤：病例报告及文献综述。
DOI：
10.1007/s00795-013-0060-x
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发表时间：
2013
期刊：
影响因子：
1.8
通讯作者：
Iwata H.
中科院分区：
文献类型：
--
作者：
Yamada T;Goto N;Tsurumi H;Takata K;Sato Y;Yoshino T;Moriwaki H;Kito Y;Takeuchi T;Iwata H.
套细胞淋巴瘤（Mantle cell lymphoma，MCL）是B细胞非霍奇金淋巴瘤的一个独特亚型，以染色体易位t（11;14）（q13;q32）、CD 5阳性和细胞周期蛋白D1过表达为特征，预后不良。我们在此报告一例MCL的73岁男性诊断为弥漫性大B细胞淋巴瘤（回肠肿瘤）在另一家医院，谁随后复发与CD 5阴性MCL。在第一次复发时，他出现颈部淋巴结肿胀，其中活检显示非典型大多形性细胞增殖，免疫组织化学和流式细胞术均为CD 5阴性。在第二次复发时，他再次发生回肠肿瘤，其中活检显示CD 5、CD 20和细胞周期蛋白D1阳性。在MCL中，CD 5阴性表达有时被报道为具有多形性和胚样变体。本例组织学上亦为多形性型，但CD 5表达由发病和第1次复发时的阴性变为第2次复发时的阳性。这是一个罕见的和有趣的情况下，因为不同的表达CD 5在各个阶段。这种现象使MCL的诊断变得困难。
Mantle cell lymphoma (MCL) is a unique subtype of B-cell non-Hodgkin’s lymphoma characterized by chromosomal translocation t(11;14)(q13;q32), positive CD5, and nuclear cyclin D1 overexpression with unfavorable prognosis. We report herein a case of MCL in a 73-year-old male diagnosed with diffuse large B-cell lymphoma (ileal tumor) at another hospital, who subsequently relapsed with CD5-negative MCL. At the 1st relapse, he developed neck lymph node swelling, of which biopsy showed proliferation of atypical large pleomorphic cells with CD5-negativity by both immunohistochemistry and flow cytometry. At the 2nd relapse, he again developed an ileal tumor, of which biopsy showed positivity for CD5, CD20, and cyclin D1. In MCL, CD5-negative expression has sometimes been reported as having pleomorphic and blastoid variants. The present case was also histologically the pleomorphic type, but the CD5 expression changed from negative at the onset and the 1st relapse to positive at the 2nd relapse. This is a rare and interesting case because of the different expression of CD5 at all stage. This phenomenon made the diagnosis of MCL difficult.