PDF(Pubmed)
Abstract：
BACKGROUND: Over the past 20 years, we have gained a deep understanding of the biological heterogeneity of diffuse large B cell lymphoma (DLBCL) and have developed a range of new treatment programs based on the characteristics of the disease, bringing us to the era of immune-chemotherapy. However, the effectiveness and molecular mechanisms of targeted-immunotherapy remain unclear in DLBCL. Targeted-immunotherapy may be beneficial for specific subgroups of patients, thus requiring biomarker assessment.
METHODS: Here, we report a case of MCD subtype DLBCL with MYD88L265P and CD79B mutations, considered in the initial stage as lymphoplasmic lymphoma (LPL) or Waldenstrom macroglobulinemia (WM). Flow cytometry supported this view; however, the immunohistochemical results of the lymph nodes overturned the above diagnosis, and the patient was eventually diagnosed with MCD subtype DLBCL. The presence of a monoclonal IgM component in the serum and infiltration of small lymphocytes with a phenotype compatible with WM into the bone marrow led us to propose a hypothesis that the case we report may have transformed from LPL/WM.
CONCLUSIONS: This highlights the possible transformation from WM to DLBCL, CD79B mutation may be a potential biomarker for predicting this conversion.
METHODS: Here, we report a case of MCD subtype DLBCL with MYD88L265P and CD79B mutations, considered in the initial stage as lymphoplasmic lymphoma (LPL) or Waldenstrom macroglobulinemia (WM). Flow cytometry supported this view; however, the immunohistochemical results of the lymph nodes overturned the above diagnosis, and the patient was eventually diagnosed with MCD subtype DLBCL. The presence of a monoclonal IgM component in the serum and infiltration of small lymphocytes with a phenotype compatible with WM into the bone marrow led us to propose a hypothesis that the case we report may have transformed from LPL/WM.
CONCLUSIONS: This highlights the possible transformation from WM to DLBCL, CD79B mutation may be a potential biomarker for predicting this conversion.
摘要：
背景：在过去的20年里，我们对弥漫性大B细胞淋巴瘤（DLBCL）的生物异质性有了深入的了解，并根据疾病的特点制定了一系列新的治疗方案，把我们带到免疫化疗的时代.然而,靶向免疫疗法在DLBCL中的有效性和分子机制尚不清楚.靶向免疫疗法可能对特定的患者亚组有益。因此需要生物标志物评估。
方法：这里，我们报告了一例MCD亚型DLBCL，MYD88L265P和CD79B突变，在初始阶段被认为是淋巴浆型淋巴瘤（LPL）或Waldenstrom巨球蛋白血症（WM）。流式细胞术支持这一观点;然而,淋巴结的免疫组织化学结果推翻了上述诊断，患者最终被诊断为MCD亚型DLBCL。血清中存在单克隆IgM成分，并且具有与WM相容的表型的小淋巴细胞浸润到骨髓中，这使我们提出了一个假设，即我们报告的病例可能已从LPL/WM转化。
结论：这突出了从WM到DLBCL的可能转变，CD79B突变可能是预测这种转化的潜在生物标志物。
方法：这里，我们报告了一例MCD亚型DLBCL，MYD88L265P和CD79B突变，在初始阶段被认为是淋巴浆型淋巴瘤（LPL）或Waldenstrom巨球蛋白血症（WM）。流式细胞术支持这一观点;然而,淋巴结的免疫组织化学结果推翻了上述诊断，患者最终被诊断为MCD亚型DLBCL。血清中存在单克隆IgM成分，并且具有与WM相容的表型的小淋巴细胞浸润到骨髓中，这使我们提出了一个假设，即我们报告的病例可能已从LPL/WM转化。
结论：这突出了从WM到DLBCL的可能转变，CD79B突变可能是预测这种转化的潜在生物标志物。
