B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma without mediastinal disease: mimicking nodular sclerosis classical Hodgkin lymphoma
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma without mediastinal disease: mimicking nodular sclerosis classical Hodgkin lymphoma
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DOI：
10.1007/s00795-013-0038-8
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发表时间：
2013-09-01
影响因子：
1.8
通讯作者：
Yoshino, Tadashi
中科院分区：
文献类型：
--
作者：
Iwaki, Noriko;Sato, Yasuharu;Yoshino, Tadashi
B细胞淋巴瘤，无法分类，具有介于弥漫性大B细胞淋巴瘤和经典霍奇金淋巴瘤之间的特征（BCLu-DLBCL/CHL），也称为灰区淋巴瘤，具有弥漫性大B细胞淋巴瘤和经典霍奇金淋巴瘤（CHL）两者的重叠临床和生物学特征。这些淋巴瘤通常与纵膈腔疾病有关，而淋巴结受累则很少见。在本报告中，我们描述了一个78岁的妇女与BCLu-DLBCL/CHL的情况下，发现有结节性病变，没有证据表明纵隔疾病。尽管活检标本在组织学上与结节性硬化CHL相似，但肿瘤细胞对CD 30和成熟B细胞标志物（如CD 20、CD 79 a、PAX 5、BOB.1和OCT-2）呈阳性，但对CD 15呈阴性。此外，患者有结节性病变和可溶性IL-2受体水平升高。这些发现在CHL中是不寻常的。因此，我们诊断患者为BCLu-DLBCL/CHL。她接受阿霉素、博莱霉素、长春新碱和达卡巴嗪治疗并表现出部分反应。一些没有纵隔疾病的病例，如我们的病例，已被报道;然而，这些病例是罕见的，需要进一步的研究。
B-cell lymphoma, unclassifiable, with features intermediate between diffuse large B-cell lymphoma and classical Hodgkin lymphoma (BCLu-DLBCL/CHL), also known as gray-zone lymphoma, has overlapping clinical and biological characteristics of both diffuse large B-cell lymphoma and classical Hodgkin lymphoma (CHL). These lymphomas are typically associated with mediastinal disease, and extranodal involvement is rare. In the present report, we describe a case of a 78-year-old woman with BCLu-DLBCL/CHL found to have extranodal lesions and no evidence of mediastinal disease. Although biopsy specimens were histologically similar to nodular sclerosis CHL, the tumor cells were positive for CD30 and mature B-cell markers, such as CD20, CD79a, PAX5, BOB.1, and OCT-2, but negative for CD15. Furthermore, the patient had extranodal lesions and an increased level of soluble IL-2 receptor. These findings are unusual in CHL. Therefore, we diagnosed the patient with BCLu-DLBCL/CHL. She received adriamycin, bleomycin, vincristine, and dacarbazine therapy and exhibited partial response. Some cases without mediastinal disease, such as our case, have been reported; however, these cases are rare and further studies are required.