转化滤泡性淋巴瘤:病理学家在辅助治疗决策中的作用

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AJSP-Reviews and Reports Pub Date : 2019-09-01 DOI:10.1097/PCR.0000000000000334

Jeremiah Pasion, Firas El Chaer, A. Rapoport, S. Dahiya, R. Koka

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引用次数: 0

摘要

滤泡性淋巴瘤(FL)是第二常见的非霍奇金淋巴瘤亚型。滤泡性淋巴瘤通常是一种惰性疾病，尽管标准化疗无法治愈，但最近治疗策略的进展改善了临床结果和生存率。随着时间的推移，FL可以获得额外的基因突变并转化为弥漫性大b细胞淋巴瘤，这是一种更具侵袭性的b细胞肿瘤，显著降低了生存率。转化型淋巴细胞的治疗是基于联合化疗和免疫治疗。利妥昔单抗已经改变了FL的治疗前景。然而，治疗转化FL的新方法正在开发中。在此，我们报告一例FL转化为弥漫性大b细胞淋巴瘤，并回顾诊断方式以及当前和即将到来的治疗方法，其中许多需要病理学家评估抗原表达模式。特别是，我们将强调病理学家在管理决策中所起的作用。

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Transformed Follicular Lymphoma: The Role of the Pathologist in Aiding Therapeutic Decision Making

Follicular lymphoma (FL) is the second most common subtype of non-Hodgkin lymphoma. Follicular lymphoma is generally an indolent disorder, and despite being incurable with standard chemotherapy, recent advances in treatment strategies have improved clinical outcomes and survival. Over time, FL could acquire additional genetic mutations and transform into diffuse large B-cell lymphoma, a more aggressive B-cell neoplasm, which markedly reduces survival. Treatment of transformed FL is based on combination chemotherapy and immunotherapy. Rituximab has changed the treatment landscape in FL. However, novel approaches to treatment of transformed FL are in development. Here, we present a case of FL with transformation to diffuse large B-cell lymphoma and review diagnostic modalities along with current and upcoming therapies, many of which require assessment of antigen expression patterns from the pathologist. In particular, we will highlight the role the pathologist plays in management decisions.

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来源期刊

AJSP-Reviews and Reports PATHOLOGY-

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期刊介绍： Each issue of Pathology Case Reviews examines one vital theme in the field with peer-reviewed, clinically oriented case reports that focus on diagnosis, specimen handling and reports generation. Each theme-oriented issue covers both histopathologic and cytopathologic cases, offering a comprehensive perspective that includes editorials and review articles of the newest developments in the field, differential diagnosis hints, applications of new technologies, reviews of current issues and techniques and an emphasis on new approaches.