| 文禄1 郭英2 谢云霞1 范国庆2 陈协群1 杨岚1△.人类免疫缺陷病毒阴性的阴道残端浆母细胞淋巴瘤
一例并文献复习*[J].,2014,14(20):3860-3862 |
| 人类免疫缺陷病毒阴性的阴道残端浆母细胞淋巴瘤
一例并文献复习* |
| A Case of Plasmablastic Lymphoma of the Vagina Stump without HumanImmunodeficiency Virus Infection and Literature Review* |
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| DOI： |
| 中文关键词: 浆母细胞淋巴瘤 人类免疫缺陷病毒 阴道残端 |
| 英文关键词: Plasmablastic lymphoma Human immunodeficiency virus Vagina stump |
| 基金项目:国家自然科学基金项目（81071951）；陕西省科技攻关项目（2010K01-163） |
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| 中文摘要: |
| 摘要目的：浆母细胞淋巴瘤(PBL)为罕见的、侵袭性极强的B细胞淋巴瘤，好发于HIV阳性患者的口腔，本文报道了目前国内外
首例HIV 阴性的原发于阴道残端的PBL，并通过文献复习总结了PBL 的临床病理学特征、诊断及鉴别诊断、治疗及预后。方法：
回顾分析该病例的临床病理学资料，并结合国内外相关文献进行讨论。结果：该患者诊断明确，HIV 阴性，以阴道残端起病，免疫
组化示MUM-1阳性，不表达CD20、CD79a 和PAX-5，Ki-67 阳性率73 %。EBER 原位杂交阴性。分子学诊断结果示：样品免疫球
蛋白基因发生克隆性重排，未检到TCR基因克隆性重排。CHOP 样方案疗效不佳，部分缓解后疾病快速进展。该患者从确诊至死
亡时间为10.3 个月。结论：PBL罕见，病情进展迅速，预后差，生存期短，在进行阴道残端肿瘤的诊断及鉴别诊断时，阴道残端PBL
应纳入鉴别范围。 |
| 英文摘要: |
| ABSTRACT Objective:Plasmablastic lymphoma (PBL) was a rare, aggressive variant of B-cell lymphoma that frequently occurred
in the oral cavity of patients with human immunodeficiency virus (HIV) infection. We reported the first case of HIV-negative PBL with
initial presentation of the vagina stump to investigate the clinicopathological characteristics, diagnosis, differential diagnosis, treatment
and prognosis of PBL. Methods:The relevant clinicopathological materials of PBL patient was retrospected and a literature review was
conducted. Results:The patient was explicitly diagnosed to be HIV negative with a vaginal stump mass as the main lesion.
Immunohistochemical examination revealed that the tumor cells were positive for MUM-1, negative for CD20, CD79a and PAX-5. The
Ki-67 proliferative index was 73%. The tumor cells were negative for EBV virus-encoded RNA in situ hybridization (EBER-ISH).
Molecular diagnostic results showed immunoglobulin gene rearrangement in the sample analyzed. TCR gene rearrangement was not
observed. CHOP-like regime showed no satisfactory effect and the disease progressed soon after a partial response. The patient died 10.3
months after the diagnosis.Conclusion: As PBL was a rare distinct variant with high malignancy, poor prognosis and shorter overall
survival, it should be included as a differential diagnosis in cases of suspected vaginal stump tumor. |
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