原发心脏弥漫大B细胞淋巴瘤5例临床病理分析

目的 探讨原发心脏弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的临床病理特点、诊断、治疗及预后.方法 回顾性分析5例原发心脏DLBCL的临床病理资料,分别行HE染色、免疫组化EnVision两步法染色,应用原位杂交以及荧光原位杂交(fluorescence in situ...

Clinicopathological analysis of primary cardiac diffuse large B-cell lymphoma

Purpose To study the clinicopathological features,diagnosis,therapy and prognosis of primary cardiac diffuse large B-cell lymphoma(DLBCL).Methods Five cases of primary cardiac DLBCL were collected and the clinicopathological data including tumor morphology,staining,immunohistochemical EnVision two-step staining,in situ hybridization and fluorescence in situ hybridization(FISH)were performed,with review of the literatures.Results Histopathologica1ly,the tumor cells were large lymphoid cells with diffuse infiltrating growth and high mitotic activity.The tumor cells were positive for CD20 and PAX5,and the Ki-67 index ranged from 60%to 95%.Tumor cells in one of the five cases were positive for CD5,with double expression of C-MYC and BCL-2.No MYC,BCL-2 or BCL-6 gene rearrangements were detected by fluorescence in situ hybridization.Two patients defaulted chemotherapy after tumor resection/biopsy and died 2 and 3 months after surgery,respectively.While another three patients treated with rituximab,cyclophosphamide,doxorubicin,vincristine and prednisone(R-CHOP)therapy after tumor resection/biopsy,and remained in good condition for 2,10 and 38 months after initial diagnosis respectively.Conclusion Primary cardiac DLBCL is a rare and highly invasive malignant tumor.In addition to the characteristic histomorphology,clinical symptoms,immunophenotypic profiles and molecular genetic detection should be combined to improve the diagnostic accuracy,so as timely and standardized therapy could be conducted accordingly.