伴浆细胞分化的弥漫大B细胞淋巴瘤一例病例报告并文献复习  

Diffuse large B cell lymphoma with plasma cell differentiation:a case report and literature review

作　　者：杨融辉[1] 廖爱军[1] YANG Rong-hui;LIAO Ai-jun(Department of Hematology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院血液内科,沈阳110004

出　　处：《实用药物与临床》2018年第6期680-682,共3页Practical Pharmacy and Clinical Remedies

基　　金：国家自然科学基金(81272629);沈阳市科技计划项目(17-231-1-58)

摘　　要：老年男性患者,以"腹股沟包块进行性肿大半年,肋骨疼痛2个月"为主诉入院,查体示脾大。既往贫血史30余年。入院化验示血清Ig M明显升高,血清免疫固定电泳示单克隆Ig M-κ阳性,外周血MYD88L265p突变阴性,骨髓涂片可见大量淋巴样浆细胞,骨髓免疫组化不除外脾边缘区淋巴瘤(SMZL)。后经淋巴结活检确诊为弥漫大B细胞淋巴瘤(DLBCL),经予CHOP方案化疗(环磷酰胺、吡柔比星、长春地辛、地塞米松)后取得部分缓解(PR)。An elderly male patient admitted to our hospital with inguinal mass progressive enlargement for half a year, rib pain for 2 months, and more than 30 years of previous history of anemia. Physical examination revealed as splenomegaly. The serum level of IgM increased significantly, immunoelectrophoresis showed monoclonal IgM-κ positive,and the MYD88 L265 P mutation in peripheral blood was negative. A large number of lymphoid-plasma cells were seen in the bone marrow smear. Splenic marginal zone lymphoma（ SMZL） could not be excluded by bone marrow immunohistochemistry.Eventually,he was diagnosed with nonGCB DLBCL based on lymph node biopsy, and partial response（ PR） was achieved after CHOP regimen.

关 键 词：弥漫大B细胞淋巴瘤(DLBCL) 脾边缘区淋巴瘤(SMZL) 浆细胞分化 

分 类 号：R733[医药卫生—肿瘤]