胸水中发现儿童腹部伯基特淋巴瘤1例并文献学习  

A Case of Abdominal Burkitt Lymphoma in a Child Discovered in Pleural Effusion and Literature Review

作　　者：高学芳 杨治理 GAO Xuefang;YANG Zhili(Medical Laboratory,Maternal and Child Health Hospital of Inner Mongolia Autonomous Region,Hohhot,010020,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古自治区妇幼保健院检验科,内蒙古呼和浩特010020

出　　处：《系统医学》2025年第2期141-144,共4页Systems Medicine

摘　　要：目的探讨1例儿童腹部伯基特淋巴瘤病例,分析该病例的临床表现和实验室检查特点,以完善儿童伯基特淋巴瘤的诊断方法,提高对儿童伯基特淋巴瘤的了解。方法收集2023年7月8日首次就诊于内蒙古自治区妇幼保健院的1例伯基特淋巴瘤病例,完善胸水流式、胸水免疫组化、融合基因、骨髓流式、脑脊液MDR检测等相关检查。结果患儿确诊为散发性伯基特淋巴瘤(Ⅲ期)。患儿胸水涂片可见一群体偏大或中等大小,呈类圆形;胞浆量较丰富伴有空泡,胞质嗜碱性强;胞核呈类圆形或不规则,可见双核及多核,部分可见1~3个核仁。胸水免疫分型提示异常细胞群占有核细胞的64.44%,表达CD19,CD10,CD81,sIgM,CD20,Kappa,FMC7,部分表达CD71,CD22,弱表达Cd79B,Cd38,提示为胞体偏大的单克隆淋巴细胞,胸水免疫组化结果为CD20+,PA×5+,CD10+,MYC阳性率约80%,BCL6+阳性率约90%+,MUM1+阳性率约70%,Ki67阳性率>90%,CD3-,CD5-,TDT-,BCL2-,提示为5-10+侵袭性B淋巴瘤。胸水基因检测到有TP53和ID3的突变。结论该伯基特淋巴瘤病例在临床中较为典型,利用该患儿的胸水样品即可完成疾病诊断。该病例的诊断过程有助于完善伯基特淋巴瘤的诊断方法,提高对儿童伯基特淋巴瘤的认识。Objective To investigate a case of abdominal Burkitt lymphoma in children,analyze the clinical manifestations and laboratory characteristics of the case,in order to improve the diagnosis of Burkitt lymphoma in children and improve the understanding of Burkitt lymphoma in children.Methods A case of Burkit lymphoma admitted to Maternal and Child Health Hospital of Inner Mongolia Autonomous Region for the first time on July 8,2023 was collected,and related examinations such as pleural fluid flow,pleural fluid immunohistochemistry,fusion gene,bone marrow flow,and cerebrospinal fluid MDR were performed.Results The patient was diagnosed with sporadic Burkitt lymphoma(stageⅢ).The pleural fluid smears of the children showed a large or medium size group with a quasi-circular shape.Abundant cytoplasm with vacuole,strong basophilic cytoplasm;The nuclei are round or irregular,with binucleus and multinucleus,and some of them have 1-3 nucleoli.The immunotyping of pleural effusion indicated that abnormal cell population occupied 64.44%of nuclear cells,expressing CD19,CD10,CD81,sIgM,CD20,Kappa,FMC7,partially expressing CD71,CD22,weakly expressing CD79B,CD38,indicating monoclonal lymphocytes with excessively large cell bodies.Immunohistochemical results of pleural fluid showed positive rates of CD20+,PAx5+,CD10+,MYC about 80%,BCL6+about 90%,MUM1+about 70%,Ki67>90%,CD3-,CD5-,TDT-,BCL2-,indicating 5-10+aggressive B lymphoma.TP53 and ID3 mutations were detected in the pleural fluid gene.Conclusion This case of Burkitt lymphoma is typical in the clinic,and the diagnosis of the disease can be completed by using the pleural fluid sample of the child.The diagnostic process of this case has helped to improve the diagnostic methods of Burkitt lymphoma and improve the understanding of Burkitt lymphoma in children.

关 键 词：伯基特淋巴瘤 儿童 胸水 

分 类 号：R4[医药卫生—临床医学]