伴复杂染色体异常的套细胞淋巴瘤一例并文献复习  

Mantle cell lymphoma with complicated chromosomal abnormality:a case report and literature review

作　　者：程月新[1] 李建勇[2] 徐卫[2] 陈天荣[1] 吴雨洁[2] 朱雨[2] 仇海荣[2] 

机构地区：[1]南通大学第四附属医院血液科,江苏盐城224006 [2]南京医科大学第一附属医院血液科,江苏南京210029

出　　处：《中华肿瘤防治杂志》2008年第14期1105-1108,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：报道伴复杂染色体异常的套细胞淋巴瘤(MCL)1例并复习相关文献。患者男,58岁。发现全身肿块1年余,常规染色体核型为92,XXYY,7q+×2,9q+×2,t(11;14)×2,13q-×2,15q+×2/46,XY[8]。I-FISH示t(11;14),M-FISH示89,XXYY,+1,+1,+2,+2,+3,+3,+4,+4,+5,+5,+6,+6,+der(6)t(6;8),+7,+der(7)t(7;9),+8,+8,der(9)t(9;15)×2,+10,+10,+del(11)(q?)×2,+12,+12,+der(13)t(3;13)×2,+der(14)t(11;14)×2,+16,+16,+17,+17,+18,+18,+19,+19,+20,+20,+21,+21,+22,+der(22)t(4;22)[20]/46,XY[11]。骨髓涂片示原始淋巴细胞22.8%,幼稚淋巴细胞10.0%;免疫表型示原幼淋巴细胞占39.9%,CD19 90%;二次摄门CD19+细胞表达:CD5 89.5%,CD20 100%,CD23阴性;淋巴结免疫组化Cyclin D1+、CD43+++、CD10-。Hyper-CVAD A及B方案交替化疗后全身肿块消失,复查骨髓:原幼淋占0.8%,流式细胞检查未见微小病灶残留(MRD),FISH结果示t(11;14)阳性细胞0/200。初步研究结果提示,对少见复杂表现的小细胞淋巴瘤可以先借助组织学和免疫表型改变来诊断大部分的病例。The objective of this article was to investigate the heterogeneity of mantle cell lymphoma （MCL） with complicated chromosomal abnormality. The patient was male and 58 years old, with general tumor for 1 year. The caryotype of convention chromosome （CC） showed as follow：92,XXYY,Tq^＋ ×2,9q^＋ ×2,t（11;14）×2,13qˉ ×2, 15q^＋ ×2/46,XY[8]; I-FISH confirmed t（11;14）; M-FISH showed as follow： 89,XXYY, ＋1, ＋1, ＋2, ＋2, ＋3, ＋3,＋4,＋4,＋5,＋5,＋6, ＋6, ＋der（6）t（6;8）, ＋ 7, ＋der（7）t（7;9）, ＋8, ＋8,der（9） t（9; 15） ×2, ＋ 10, ＋ 10, ＋del（11）（ q？）×2,＋12,＋12,＋der（13）t（3;13）×2,＋der（14）t（11;14）×2,＋16,＋16,＋17,＋17,＋18,＋18, ＋19,＋19,＋20,＋20,＋21,＋21,＋22,＋der（22）t（4;22）[20]/46,XY[11]. Bone marrow slides： primitive lymphocyte 22.8%, immature lymphocyte 10.0K; immunophenotype with FCM primitive and immature lymphocyte 39.9%, CD5：89.5%, CD19：90%, CD20： 100%, CD23： （-）; lymphnode： Cyclin D1^＋, CD43^＋＋＋, CD10ˉ. After received chemotherapy with Hyper-CVAD A and B, the patient＇s tumors were disappeared. Bone marrow was rechecked： primitive and immature lymphocytes 0.8%, positive cell of t（11;14）0/200, and minimal residual disease was not check by FCM. In conclusion, the changes of histology and immunophenotype can be used to diagnose most of the small cell lymphoma with complicated appearance.

关 键 词：淋巴瘤/遗传学 染色体障碍 原位杂交 荧光 

分 类 号：R733.1[医药卫生—肿瘤]