易误诊为ALCL的CD30阳性DLBCL 1例并文献复习

Diffuse Large B-Cell Lymphoma with CD30-Positive Easily Misdiagnosed as ALCL: 1 Case Report and Literature Review

摘要: 目的：提高对CD30阳性的弥漫大B细胞淋巴瘤(DLBCL)的认识。方法：回顾性分析2022年4月陕西省人民医院收治1例免疫组织化学染色CD30弥漫表达的DLBCL患者的临床资料，并进行文献复习。结果：患者为76岁男性，于外院行超声检查提示颈部3、4区淋巴结肿大，并行颈部淋巴结穿刺活检，结合其组织形态学特点及免疫组织化学染色等诊断为CD30阳性的弥漫大B细胞淋巴瘤。予BV联合CHP方案化疗2疗程，CHOP联合来那度胺方案化疗6疗程，患者肿大淋巴结较前明显缩小，疗效评估接近完全缓解。结论：CD30弥漫阳性的DLBCL较为罕见，其免疫表型及组织学形态与经典型ALCL相似，应尽早行组织病理学检查，明确诊断，尽早治疗。

Abstract: Objective: To enhance understanding of CD30-positive Diffuse Large B-Cell Lymphoma (DLBCL). Methods: A retrospective analysis was conducted on the clinical data of a patient with immuno-histochemically stained CD30-positive DLBCL, treated in April 2022 at the Shaanxi Provincial Peo-ple’s Hospital. This included a review of relevant literature. Results: The patient, a 76-year-old male, presented with enlarged lymph nodes in regions 3 and 4 of the neck, as identified by ultrasound examination in another hospital. A neck lymph node biopsy, combined with histomorphological characteristics and immunohistochemical staining, led to the diagnosis of CD30-positive DLBCL. The patient underwent two cycles of chemotherapy with the BV + CHP regimen and six cycles with the CHOP + Lenalidomide regimen. There was a significant reduction in the size of the enlarged lymph nodes, and the therapeutic effect was assessed as nearing complete remission. Conclusion: CD30-positive DLBCL is relatively rare, with an immunophenotype and histological morphology similar to classical Anaplastic Large Cell Lymphoma (ALCL). Early histopathological examination for definitive diagnosis and prompt treatment is recommended.