CD10–MUM1+滤泡性淋巴瘤一例及文献学习

CD10–MUM1+Follicular Lymphoma: A Case Report and Review of the Literature

摘要: 目的：我院会诊一例外院无明确诊断、外周淋巴结肿大的老年患者，为明确诊断特做形态学、免疫组化及分子遗传学检测。方法：常规对福尔马林固定、石蜡包埋的淋巴结组织切片，做HE、免疫组化染色及荧光原位杂交实验。结果：免疫组化结果：瘤细胞CD20(+)、PAX-5(+)、BCL-2(+)、Mum1(+)、Bcl-6弱(+)、CD10(–)、CD23(+)、CD21(+)、CD43(–)、CyclinD1(–)，Ki67增殖指数约50%。原位荧光杂交结果：IgH/BCL2易位(+)，BCL6易位(–)。结论：本文介绍的滤泡性淋巴瘤病例符合较为少见的MUM1(+) CD10(–)滤泡性淋巴瘤亚型(80%)伴有弥漫性大B细胞淋巴瘤区域(20%)，分级为3级b，据报道其预后较差，应当视作侵袭性淋巴瘤治疗。 Objective: In order to make definate diagnosis to an old patient with multiple lymph-node enlargement in the area of groin and submaxilla we made morphology and molecularbiology study. Methods: We carried out slice cut-ting from formalin fixed paraffin embedded tissue, then make HE and immunostaining. After that Fluorescence in situ hybridization (FISH) was performed to detect genetic abnormalities. Results: Immunostaining: CD20(+), PAX-5(+), BCL-2(+), Mum1(+), Bcl-6 weak(+), CD10(–), CD23(+), CD21(+), CD43(–), CyclinD1(–), Ki67 index was about 50%. FISH: IgH/BCL2 translocation (+), BCL6 translocation (–). Conclusion: The case we are intruducing here belongs to the rare subtype of follicular lymphoma which chracterized by MUM1(+) CD10(–) immunostaining marker. The pa-thology diagnosis is follicular lymphoma (MUM1(+) CD10(–)) (80%) with diffuse area(20%), degree: 3b. The progno-sis of this kind of follicular lymphoma is not good and should be treated as aggressive B cell lymphoma.