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目的探讨浆母细胞淋巴瘤的病理诊断和临床病理特点。方法对1例浆母细胞淋巴瘤进行详细的临床病理分析、免疫组化标记、原位杂交和基因重排检测,并复习相关文献。结果肿瘤组织呈弥漫浸润性生长,瘤细胞较大,圆形或椭圆形,胞质丰富,细胞核偏位,可见1～2个核仁,核分裂象易见,可见凋亡小体及星空现象。免疫组化:瘤细胞CD138、VS38c、vimentin和VEGF(+),CD3、CD68、LCA和p53散在(+),Ki-67>50%。PCR检测结果示IgH基因重排。结论浆母细胞淋巴瘤是一种弥漫增生的恶性肿瘤,肿瘤细胞与B免疫母细胞相似,但是肿瘤细胞具有浆细胞的免疫表型。浆母细胞淋巴瘤的诊断依赖于组织病理学和免疫组化并结合相关的分子病理技术。
Objective To investigate the pathological diagnosis and clinicopathological features of plasmablastic lymphoma. Methods A case of plasmablastic lymphoma was studied by clinicopathological analysis, immunohistochemical staining, in situ hybridization and gene rearrangement. The related literatures were reviewed. Results The tumor tissues were diffusely infiltrating. The tumor cells were large, round or oval, rich in cytoplasm, and deviated in nuclei. There were 1-2 nucleoli. The mitotic figures were easily seen, and apoptotic bodies and the starry sky were visible. Immunohistochemistry: tumor cells CD138, VS38c, vimentin and VEGF (+), CD3, CD68, LCA and p53 were scattered (+), Ki-67> 50%. PCR results showed IgH rearrangement. Conclusion Plasmacytoid lymphoma is a malignant tumor with diffuse proliferation. The tumor cells are similar to B immunoblastic cells, but the tumor cells have the immunophenotype of plasma cells. The diagnosis of plasmablastic lymphoma relies on histopathology and immunohistochemistry in combination with related molecular pathology techniques.