A case of high-grade transformation of splenic diffuse red pulp small B-cell lymphoma
10.3760/cma.j.cn114452-20250122-00039
- VernacularTitle:脾弥漫性红髓小B细胞淋巴瘤高级别转化1例
- Author:
Mingkang YANG
1
;
Jianbiao WANG
;
Huijin ZHAO
;
Ping GUO
Author Information
1. 上海交通大学医学院附属瑞金医院检验科，上海 200025
- Publication Type:Journal Article
- Keywords:
Lymphoma;
Splenic diffuse red pulp small B-cell lymphoma;
High grade lymphoma;
Chimeric antigen receptor T-cell immunotherapy
- From:
Chinese Journal of Laboratory Medicine
2025;48(5):670-674
- CountryChina
- Language:Chinese
-
Abstract:
A case of a 51-year-old male presented with leukocytosis, lymphocytosis, and splenomegaly. Comprehensive diagnostic evaluations, including cytomorphology, flow cytometric immunophenotyping, and splenic pathology, confirmed the diagnosis of splenic diffuse red pulp small B-cell lymphoma (SDRPL). The patient tested was positive for TP53 mutation and demonstrated poor response to various chemotherapy regimens. During follow-up, the patient′s condition deteriorated. PET-CT revealed multiple metabolically active lymph nodes throughout the body. Peripheral blood smear revealed abnormal lymphocytes, which suggests potential high-grade transformation. Pathological examination of axillary lymph nodes indicated lymphoma cell infiltration, with positive expression of BCL-2, BCL-6, and C-MYC. Subsequent treatment with Zanubrutinib+Obinutuzumab+Bendamustine yielded suboptimal results. Chimeric antigen receptor T-cell immunotherapy (CAR-T) was subsequently administered, and after 9 months, minimal residual disease (MRD) evaluation was negative. SDRPL is a rare indolent B-cell lymphoma, and its diagnosis relies on splenic pathology. The abnormal lymphocytes exhibit characteristic villous projections, and monitoring morphological changes during follow-up can indicate disease progression, providing a basis for selecting appropriate treatment strategies.
