原发骨髓弥漫大B细胞淋巴瘤1例报告及文献复习

doi:10.13481/j.1671-587x.20160435

吉林大学学报(医学版) ›› 2016, Vol. 42 ›› Issue (04): 817-820.doi: 10.13481/j.1671-587x.20160435

原发骨髓弥漫大B细胞淋巴瘤1例报告及文献复习

张文龙¹, 杨华², 孙延霞¹

1. 吉林大学中日联谊医院肿瘤血液科, 吉林长春 130033;
2. 吉林大学中日联谊医院病理科, 吉林长春 130033

收稿日期:2015-11-05 发布日期:2016-07-20
通讯作者: 孙延霞,副教授,硕士研究生导师(Tel:0431-84995797,E-mail:1103019069@qq.com)。 E-mail:1103019069@qq.com
作者简介:张文龙(1982-),男,吉林省松原市人,主治医师,在读医学博士,主要从事血液系统疾病基础和临床方面的研究。
基金资助:
吉林省科技厅自然科学基金资助课题（201215069）

Primary bone marrow diffuse large B-cell lymphoma: One case report and literature review

ZHANG Wenlong¹, YANG Hua², SUN Yanxia¹

1. Department of Hematology and Oncology, China-Japan Union Hospital, Jilin University, Changchun 130033, China;
2. Department of Pathology, China-Japan Union Hospital, Jilin University, Changchun 130033, China

Received:2015-11-05 Published:2016-07-20

摘要/Abstract

摘要：

目的：分析1例原发骨髓弥漫大B细胞淋巴瘤（DLBCL）的诊断和治疗情况为该病的诊治提供参考。方法：结合本例患者病史及其他辅助检查结果，高度怀疑为原发骨髓淋巴瘤（PBML）。经骨髓病理检查及免疫组织化学染色确诊为DLBCL，并给予化疗。结果：本例患者符合PBML诊断标准，根据骨髓免疫组织化学染色结果将其划分至DLBCL亚型。患者接受利妥昔单抗+环磷酰胺、表柔比星、长春新碱及泼尼松（R-CHOP）方案化疗1个周期后达骨髓细胞形态学完全缓解，又行该方案化疗5个周期，现停药随访3个月仍为完全缓解。结论：骨髓病理及免疫组织化学染色对原发骨髓DLBCL具有重要的诊断价值，含利妥昔单抗的化疗方案近期疗效理想。

关键词: 原发骨髓淋巴瘤, 弥漫大B细胞淋巴瘤, 骨髓病理

Abstract:

Objective: To analyze the diagnosis and treatment of 1 case of primary bone marrow diffuse large B cell lymphoma (DLBCL), and to provide the reference for its dignosis and treatment. Methods: Combined the medical history and other auxiliary examination results, the possibility of diagnosis of primary bone marrow lymphoma(PBML) was suspected. Bone marrow biopsy and immunohistochemistry were carried out for diagnosis, and R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) was selected as the chemotherapy scheme. Results: The diagnostic basis of the case was in accordance with the diagnostic standard of PBML. According to the results of immunohistochemical staining, it was classified as the DLBCL subtype. Then the patient received 6 cycles of R-CHOP immune chemotherapy. Complete remission of bone marrow cell morphology was gained after the first cycle of R-CHOP treatment, and the patient was treated for another five cycles and the complete remission was retained in 3 months of follow up after drug withdrawal. Conclusion: Bone marrow biospy and immunohistochemistry have the unique diagnostic values for primary bone marrow DLBCL, and the regimens containing rituximab may provide a ideal efficacy during short term observation.

Key words: primary bone marrow lymphoma, diffuse large B cell lymphoma, bone marrow biopsy

中图分类号:

R733.4

张文龙, 杨华, 孙延霞. 原发骨髓弥漫大B细胞淋巴瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2016, 42(04): 817-820.

ZHANG Wenlong, YANG Hua, SUN Yanxia. Primary bone marrow diffuse large B-cell lymphoma: One case report and literature review[J]. Journal of Jilin University Medicine Edition, 2016, 42(04): 817-820.

参考文献

[1] Kajiura D, Yamashita Y, Mori N. Diffuse large B-celllymphoma initially manifesting in the bone marrow [J]. Am J ClinPathol,2007,127(5):762-769.

[2] Chang H, Hung YS, Lin TL,et al. Primary bone marrowdiffuse large B cell lymphoma: a case series and review [J].Ann Hematol,2011,90(7):791-796.

[3] Martinez A, Ponzoni M, Agostinelli C, et al. Primary bone marrow lymphoma: an uncommon extranodal presentation of aggressive non-Hodgkin lymphomas [J]. Am J Surg Pathol,2012,36(2): 296-304.

[4] Alvares CL, Matutes E, Scully MA, et al. Isolated bone marrowinvolvement in diffuse large B cell lymphoma: a report of threecases with review of morphological,immunophenotypic andcytogenetic findings [J]. Leuk Lymphoma,2004,45(4):769-775.

[5] Kong SY, Cho EH, Woo HY, et al. De novo CD5 positive diffuse large B-cell lymphomas with bone marrow involvement in Korean [J]. J Korean Med Sci,2004,19(6):815-819.

[6] Strauchen JA. Primary bone marrow B-cell lymphoma:report of four cases[J]. Mt Sinai J Med,2003,70(2):133-138.

[7] Kagoya Y,Sahara N,Matsunaga T,et al. A case of primary bone marrow B-cell non Hodgkin's lymphoma with severe thrombocytopenia:case report and a review of the literature [J]. Indian J Hematol Blood Transfus,2010,26(3):106-108.

[8] 刘慧敏,易树华,刘恩彬,等。原发骨髓弥漫大B细胞淋巴瘤三例报告并文献复习 [J].中华血液学杂志,2014,35(10):914-917.

[9] Arber DA, George TI. Bone marrow biopsy involvement by non-Hodgkin's lymphoma: frequency of lymphoma types,patterns, blood involvement, and discordance with other sites in 450 specimens [J].Am J Surg Pathol,2005,29(12):1549-1557.

[10] Torlakovic E, Torlakovic G, Brunning RD. Follicular pattern of bone marrow involvement by follicular lymphoma [J]. Am J Clin Pathol,2002,118(5):780-786.

[11] Yamaguchi M, Seto M, Okamoto M, et al. De novo CD5⁺ diffuse large B-cell lymphoma: a clinicopathologic study of 109 patients [J]. Blood,2002,99(3):815-821.

[12] Merli M, Arcaini L, Boveri E,et al. Assessment of bone marrow involvement in non-Hodgkin's lymphomas: comparison between histology and flow cytometry [J].Eur J Haematol,2010,85(5):405-415.

[13] 张文龙,许人,白元松,等.以骨髓侵犯为唯一表现FCM检测阴性的淋巴瘤1例报道并文献复习 [J].中国实验诊断学,2012,16(6):1141-1142.

[14] Kazama H, Teramura M, Yoshinaga K,et al. Long-term remission of primary bone marrow diffuse large B-cell lymphoma treated with high-dose chemotherapy rescued by in vivo rituximab-purged autologous stem cells [J].Case Rep Med,2012,2012:957063.

原发骨髓弥漫大B细胞淋巴瘤1例报告及文献复习

Primary bone marrow diffuse large B-cell lymphoma: One case report and literature review

RichHTML

PDF (PC)

赞

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 8

Metrics

本文评价

推荐阅读 0

[1]	高欢, 白元松, 代恩勇, 韩冷, 卢振霞, 赵亚男. 复发/难治性儿童B淋巴母细胞淋巴瘤1例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(02): 416-420.
[2]	李小霞, 孙艳, 曲荣锋, 任立参, 李亚荣. 原发性乳腺弥漫大B细胞性淋巴瘤3例报告及文献复习[J]. 吉林大学学报(医学版), 2018, 44(01): 166-169.
[3]	秦贝贝, 李亚青, 李小丽, 路礼莎, 张旭东, 张明智. Wnt/β-catenin通路关键分子在NK/T细胞淋巴瘤组织中的表达及其临床意义[J]. 吉林大学学报(医学版), 2015, 41(02): 230-234.
[4]	胡彦伟,张明智,曹玲,张旭东,刘倩倩,韩丽娟,胡腾鹏,杨黎,文建国. Notch信号分子在人NK细胞淋巴瘤细胞中的表达及其意义[J]. 吉林大学学报(医学版), 2013, 39(4): 657-660.
[5]	王铁延\|杨华\|王连有\|王英\|卢振霞\|张丽荣\|崔亚南. 芯针穿刺活检在恶性淋巴瘤诊断中的应用[J]. J4, 2011, 37(2): 335-338.
[6]	刘淑春，赵文举，吕喆，李艳博，康顺爱，龚守良. 低剂量辐射诱导EL-4淋巴瘤细胞凋亡及细胞周期进程适应性反应的剂量率效应[J]. J4, 2008, 34(1): 24-27.
[7]	张福明，李凡. 分枝扩增法检测鼻咽癌患者外周血EB病毒基因[J]. J4, 2004, 30(1): 105-107.
[8]	吕品, 尹金植, 刘晶, 孙杨, 刘丽英, 任锦, 马忠森. 纤维支气管镜下氩等离子凝固及冷冻治疗气管黏膜相关淋巴组织淋巴瘤1例及文献复习[J]. 吉林大学学报(医学版), 2016, 42(01): 152-154.