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Case Reports
. 2025 Apr 8;54(4):397-399.
doi: 10.3760/cma.j.cn112151-20240901-00585.

[Composite diffuse large B-cell lymphoma and CD5-negative mantle cell lymphoma: report of a case]

[Article in Chinese]
X J Li  1 , L B Tang  2 , Y Y Liu  1 , X J Wang  3 , Y P Chen  3
Affiliations
Case Reports

[Composite diffuse large B-cell lymphoma and CD5-negative mantle cell lymphoma: report of a case]

[Article in Chinese]
X J Li et al. Zhonghua Bing Li Xue Za Zhi. .

Abstract

报道复合性弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL）和CD5阴性套细胞淋巴瘤（mantle cell lymphoma，MCL）1例。患者男，83岁。乏力半个月、发热半天于2021年5月入院，行腹股沟淋巴结及骨髓活检。镜下观察，淋巴结结构完全破坏，由2个区域构成，颜色稍浅区见片状异型大细胞，圆形或不规则形泡状核，可见突出的核仁，核分裂象易见，免疫组织化学呈CD20、PAX5、bcl-6、MUM1阳性，CD5、cyclin D1和SOX11阴性，诊断为DLBCL；颜色较深区淋巴样细胞大小一致，中等大小，核略不规则，无明显核仁，表达CD20、PAX5、cyclin D1和SOX11标志物，CD5、bcl-6和MUM1阴性，诊断为CD5阴性MCL。2个区域均可见散在EB病毒编码的RNA阳性细胞。荧光原位杂交（FISH）检测显示MCL呈CCND1基因重排阳性，DLBCL呈重排阴性。Ig基因重排检测提示2个区域肿瘤细胞具有相同的克隆峰。骨髓活检组织内见CD5阴性MCL累及。DLBCL合并CD5阴性MCL罕见，这种复合性淋巴瘤给诊断及治疗带来极大的挑战，通常需要完整切除病变淋巴结并应用包含CD5、Cyclin D1和SOX11的免疫组织化学组合才能明确诊断。治疗上尚无统一的标准，应同时考虑合并的不同淋巴瘤种类以制定最佳治疗方案。.

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