Diagnostic analysis of seven subtypes of mature small B-cell lymphoma involving the bone marrow and peripheral blood
10.3760/cma.j.cn341190-20220715-00579
- VernacularTitle:累及骨髓和外周血的成熟小B细胞淋巴瘤7种亚型的诊断分析
- Author:
Haoxiang LU
1
;
Jing XU
;
Hongchun QIU
;
Rong KONG
;
Dehong WU
Author Information
1. 昆山市第三人民医院血液科，昆山 215316
- Keywords:
Leukemia,lymphocytic,chronic,B-cell;
sLymphoma,B-cell,marginal zone;
Lymphoma,follicular;
Lymphoma;
Waldenstrom macroglobulinemia;
Diagnosis,differential
- From:
Chinese Journal of Primary Medicine and Pharmacy
2023;30(9):1308-1313
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the diagnosis and differential diagnosis methods of chronic mature small B-cell lymphoma involving the bone marrow and peripheral blood.Methods:The clinical data of 27 patients with mature small B-cell lymphoma involving the bone marrow and peripheral blood (seven subtypes phase IV) who received treatment in the Kunshan Third People's Hospital from February 2015 to June 2021 were retrospectively analyzed. The application value of different detection methods in the diagnosis of mature small B-cell lymphoma involving the bone marrow and peripheral blood was analyzed.Results:The majority of patients' peripheral blood was mainly characterized by an increase in the ratio or absolute value of lymphocytes. In terms of cell morphology, mature lymphocytes were mainly small to medium in size. A few bone marrow smears or peripheral blood smears show characteristic changes in cell morphology. Flow cytometry results showed that among the cohort of 15 patients presenting CD5 expression, 11 patients had chronic lymphocytic leukemia, 1 patient had mantle cell lymphoma, 1 patient had splenic diffuse red pulp small B-cell lymphoma, and 2 patients had B-cell chronic lymphoproliferative disorders (unclassified). Among 12 patients presenting no CD5 expression, 8 had Waldenstr?m's macroglobulinemia, 3 had splenic marginal zone lymphoma, and 1 had follicular lymphoma. Among the 2 patients presenting CD5-CD10 expression, 1 patient had follicular lymphoma, and 1 patient had Waldenstr?m's macroglobulinemia. One patient with splenic diffuse red pulp small B-cell lymphoma expressed CD5, CD11c, and CD103 in addition to pan-B-cell markers, while BRAF V600E mutation detection and immunohistochemical staining for tartrate-resistant acid phosphatase and annexin-1A showed negative expression.Conclusion:This type of lymphoproliferative disease is a general term for lymphoma that has various different molecular and biological characteristics. Its diagnosis and differential diagnosis need to comprehensively consider the clinical characteristics of the patient, relevant laboratory tests, cell morphology, flow cytometry detection results, reasonable use of fluorescence in situ hybridization, molecular biology, special chemistry, and bone marrow immunohistochemistry. In a few cases, diagnosis of the lymphoproliferative disease still relies on non-bone marrow involvement and tissue biopsy.
