A case of AL amyloidosis associated with follicular lymphoma with plasmacytic differentiation
A case of AL amyloidosis associated with follicular lymphoma with plasmacytic differentiation
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AL淀粉样变性伴浆细胞分化滤泡性淋巴瘤1例
DOI：
10.1007/s12185-019-02734-7
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发表时间：
2019
影响因子：
2.1
通讯作者：
M. Taniwaki
中科院分区：
文献类型：
--
作者：
Yosuke Matsumoto;T. Masuda;Ayako Nishimura;H. Horie;K. Harada;Mihoko Yoshida;K. Shimura;H. Kaneko;M. Taniwaki
一位58岁的女性在我院诊断为肠套叠，接受了紧急手术切除小肠。切除回肠标本的组织病理学诊断为淀粉样蛋白轻链（AL）淀粉样变性。手术切除后的结肠镜检查和结肠活检标本的组织病理学分析显示滤泡性淋巴瘤（FL） 1级伴浆细胞分化。这些回肠和结肠病变的组织学表现是特征性的。在回肠，检测到cd10阳性淋巴滤泡和cd38阳性滤泡间浆细胞向绒毛浸润。淀粉样蛋白沉积局限于回肠，邻近淋巴滤泡和滤泡间浆细胞。此外，石蜡包埋组织切片（tissue-FISH）的荧光原位杂交（FISH）显示，滤泡病变的B细胞和滤泡间浆细胞均显示IGH / BCL2融合信号，表明滤泡间浆细胞来源于分化的肿瘤滤泡B细胞。患者接受了6个疗程的淋巴瘤化疗，完全缓解，无淀粉样变相关症状。需要进一步的病例分析来澄清临床病理结果，并建立与FL相关的AL淀粉样变性和伴浆细胞分化的FL的治疗策略。
A 58-year-old woman underwent emergency surgical resection of the small intestine for intussusception as diagnosed at our hospital. Histopathological diagnosis of the resected specimen of the ileum was amyloid light chain (AL) amyloidosis. The colonoscopy after the surgical resection and following histopathological analysis of the biopsied specimens of the colon revealed follicular lymphoma (FL) grade 1 with plasmacytic differentiation. Histological findings of these ileal and colonic lesions were characteristic. In the ileum, CD10-positive lymphoid follicles and CD38-positive interfollicular plasma cell infiltration into villi were detected. The amyloid deposition was localized to the ileum and was adjacent to lymphoid follicles and interfollicular plasma cells. Furthermore, fluorescence in situ hybridization (FISH) for paraffin-embedded tissue sections (tissue-FISH) revealed that both the B cells in follicular lesions and the interfollicular plasma cells showed IGH / BCL2 fusion signals, which means the interfollicular plasma cells were originated from the differentiated neoplastic follicular B cells. The patient was treated with six courses of lymphoma chemotherapy and attained complete remission without any symptoms associated with amyloidosis. Further case analyses are needed to clarify the clinicopathological findings and to establish therapeutic strategy of AL amyloidosis associated with FL and FL with plasmacytic differentiation.
滤泡中心细胞（FCC）淋巴瘤的浆细胞分化。
影响因子：
3.5
作者：
Keith,TA;Cousar,JB;Glick,AD;Vogler,LB;Collins,RD
通讯作者：
Collins,RD