WikiPathologica
Primary testicular lymphoma ¸¶È¯ÀÀºÁã¥ê¥ó¥Ñ¼ð †
¶µ²Ê½ñ*1ʸ¸¥*2*3*4*5*6
âдݼðáç¤Î5%¤¬¥ê¥ó¥Ñ¼ð¤Ç, 50ºÐ°Ê¾å¤ÎÃËÀ¤Îâдݼðáç¤ÇºÇ¤â¹âÉÑÅÙ. ¾®»ù¤Ï¤´¤¯¤Þ¤ì. Ê¿¶ÑǯÎð¤Ï50ºÐÂå¸åȾ¤è¤ê60ºÐÂå.
ξ¦âдݼðáç¤ÇºÇ¤â¹âÉÑÅ٤ʤΤ¬¥ê¥ó¥Ñ¼ð. HIVÍÛÀ´µ¼Ô¤µ¤ó¤Ï¾¯¤Ê¤¤. âдݰÀ¥ê¥ó¥Ñ¼ð¤ÎÁǰø¤Ï¤ï¤«¤Ã¤Æ¤¤¤Ê¤¤.
ŵ·¿Îã¤Ç¤Ï, ¹Å¤¤ÄˤߤΤʤ¤±¢Ç¹¼ðáî
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ÀºÁã¤ÏÌÈ±ÖÆÃ¸¢¤Ë¤è¤êÊݸ¤ì¤¿Â¡´ï †
¸¶È¯Àâдݥê¥ó¥Ñ¼ð¤Ï¸¶È¯ÀÂçǾ¥ê¥ó¥Ñ¼ð¤ÈƱÍͤËimmune-privileged(ÌÈ±ÖÆÃ¸¢)site¤ËȯÀ¸¤·, ·ì±Õ-âдݥХꥢ¤Ë¤è¤êÌȱÖÈ¿±þ¤è¤êËɸ椵¤ì¤Æ¤¤¤ë.*7
ÌÈ±ÖÆÃ¸¢¡Êimmune privilege¡ËÁ´¿È¤ÎÌȱַϤ«¤é³ÖÀ䤵¤ì¤Æ¤¤¤ë¡¤Â¡´ïÆâ¤Ç¼«¸ÊÀ©¸æ¤µ¤ì¤Æ¤¤¤ë¤Ê¤É¤ÎÍýͳ¤Ë¤è¤êÌȱֱþÅú¤ä±ê¾ÉÈ¿±þ¤Ê¤É¤¬µ¯¤³¤ê¤Ë¤¯¤¤À¼Á¤Î¤³¤È¡¥ÌÈ±ÖÆÃ¸¢¤¬¤¢¤ë¤È¡´ï°Ü¿¢¤ÎºÝ¤ËµñÀäÈ¿±þ¤¬µ¯¤³¤ê¤Ë¤¯¤¤¤³¤È¤«¤é°Ü¿¢À®¸ùΨ¤¬¹â¤¤¤È¤µ¤ì¤ë¡¥Ç¾¡¤´ã¡Ê³ÑËì¡Ë¡¤ÌÓȱ¡¤ÀºÁ㡤Êì¿Æ¤Î»ÒµÜÆâ¤ÎÂÛ»ù¤Ê¤É¤ËÌÈ±ÖÆÃ¸¢¤¬¤¢¤ë¤È¹Í¤¨¤é¤ì¤Æ¤¤¤ë¡¥*8
ÃËÀÀ¸¿£ºÙ˦¤ÏÂÛÀ¸´ü8½µ¤«¤éÀºÁĺÙ˦¤È¤·¤ÆÀºÁãÆâ¤Ë¸ºß¤¹¤ë. ¤·¤«¤·»×½Õ´ü¤Ë¤Ê¤Ã¤Æ¤«¤éÀºÁĺÙ˦¤¬ÀºÊìºÙ˦¤Ëʬ²½Áý¿£¤·¡¢¤µ¤é¤Ë¸º¿ôʬÎö¤·¤ÆÀº»Ò¡¦Àº»ÒºÙ˦¤¬½Ð¸½¤¹¤ë¤¿¤á, Àº»Ò¡¦Àº»ÒºÙ˦¤Ï, ÍÄ»ù´ü¤Þ¤Ç¤ËÈ󼫸ʤòÇÓ½ü¤¹¤ëµ¡Ç½¤ò³ÎΩ¤·¤Æ¤¤¤ëÌȱ֥·¥¹¥Æ¥à¤Ë¤È¤Ã¤ÆÈ󼫸ʤÈǧ¼±¤µ¤ì¤ë¼«¸Ê¹³¸¶¤òͤ¹¤ë¤³¤È¤Ë¤Ê¤ë.
¤³¤Î¼«¸Ê¹³¸¶¤òͤ¹¤ëÀº»Ò¡¦Àº»ÒºÙ˦¤ò¼é¤ë¤¿¤á¡¢ÀºÁã¤Ë¤Ï¼«¸ÊÌȱÖÈ¿±þ¤òÍÞÀ©¤¹¤ëÍÍ¡¹¤Ê¥á¥«¥Ë¥º¥à-ÌÈ±ÖÆÃ¸¢(immune privilege ¡Ë¤¬Â¸ºß¤¹¤ë.*9
- 1. ÀººÙ´É¤Î¾åÈéºÙ˦¤Ç¤¢¤ë¥»¥ë¥È¥êºÙ˦´Ö¤ÎÌ©Ãå·ë¹çÃÁÇò¤Ê¤É¤Ç¹½À®¤µ¤ì¤ë·ì±Õ¡ÝÀºÁã´ØÌç¡ÊBlood-testis barrier: BTB¡Ë
¼Â¸³Åª¤ËBTB¤Îµ¡Ç½¾ã³²¤òµ¯¤³¤¹¤È¡¢ÀºÁã¤Ë¥ê¥ó¥Ñµå¤òȼ¤¦±ê¾É¤¬Í¶Æ³¤µ¤ì¡¢Àº»Ò·ÁÀ®¾ã³²¤òȯ¾É¤¹¤ë»ö¤¬Êó¹ð¤µ¤ì¤Æ¤ª¤ê¡¢BTB¤¬ÀººÙ´ÉÆâ¤ÎÀº»Ò¡¦Àº»ÒºÙ˦¤Ë¸ºß¤¹¤ë¼«¸Ê¹³¸¶¤òÀººÙ´É³°¤ÎÌȱַϤ«¤é³ÖÀ䤷¤Æ¤¤¤ë»ö¤¬¼¨º¶¤µ¤ì¤Æ¤¤¤ë.
- 2. ÀººÙ´É³°¤Î´Ö¼Á(ÀººÙ´É·ä)¤ÏÌ®´É³°Ä̱ÕÏ©¤È¸Æ¤Ð¤ì¡¢¥ê¥ó¥Ñ±Õ¤¬½Û´Ä¤·¤Æ¤¤¤ë¤³¤È¤¬ÃΤé¤ì, ¤½¤Î¥ê¥ó¥Ñ±Õ¤Ï¡¢ÀºÁã´Ö¼Á¤ò½Û´Ä¤·¡¢ÀºÁãÇòËì¤Ë³«¸ý¤¹¤ë¥ê¥ó¥Ñ´É¤«¤éή½Ð¤·¤Æ¤¤¤¯.*10
ÀºÁã¤Î´Ö¼Á¤Ë¤Ï¡¢¥é¥¤¥Ç¥£¥ÒºÙ˦¤¬¿ô¿¤¯Â¸ºß¤·¡¢¥¹¥Æ¥í¥¤¥É¤Î°ì¼ï¤Ç¤¢¤ë¥Æ¥¹¥È¥¹¥Æ¥í¥ó¤òʬÈ礷¤Æ¤ª¤ê, ¥ê¥ó¥Ñ±Õ¤Ë¤Ï¡¢ÌȱÖÍÞÀ©¸ú²Ì¤òͤ¹¤ë¥Æ¥¹¥È¥¹¥Æ¥í¥ó¤¬ËÉÙ¤Ë´Þ¤Þ¤ì¤Æ¤¤¤ë.*11
- 3.ÍÍ¡¹¤Ê¥µ¥¤¥È¥«¥¤¥ó¤¬À¸ÍýŪ¤ËÀºÁã´Ö¼Á¤ÎÌȱÖÍÞÀ©µ¡¹½¤Ë´ØÍ¿¤·¤Æ¤¤¤ë¤³¤È¤¬ÌÀ¤é¤«¤Ë¤Ê¤Ã¤Æ¤¤¤ë.*12
- ÍÞÀ©À¤Î¥µ¥¤¥È¥«¥¤¥ó¤È¤·¤Æ¤è¤¯ÃΤé¤ì¤Æ¤¤¤ëInterleukin¡ÊIL¡Ë-10¤¬¡¢¥é¥¤¥Ç¥£¥ÒºÙ˦¤ä¥Þ¥¯¥í¥Õ¥¡¡¼¥¸¤«¤éÀºÁã´Ö¼Á¤ØÊ¬È礵¤ìÌȱ֤òÍÞÀ©¤·¤Æ¤¤¤ë.
- ¤½¤Î¾, activin¤ä¡¢tranforming growth factor-¦Â¡Ê TGF-¦Â¡Ë¤¬¥»¥ë¥È¥êºÙ˦¤ä¥é¥¤¥Ç¥£¥ÒºÙ˦¤«¤éÀºÁã´Ö¼Á¤ËʬÈ礵¤ìÌȱÖÍÞÀ©ºîÍѤòͤ·¤Æ¤¤¤ë¤³¤È¤¬Êó¹ð¤µ¤ì¤Æ¤¤¤ë.
- ÍÞÀ©·Ï¥µ¥¤¥È¥«¥¤¤È¤·¤ÆÃΤé¤ì¤Æ¤¤¤ëIL-35¤Î¹½À®Ê¬»Ò¤Ç¤¢¤ëEpstein-Barr virus-Induced gene-3 ¡ÊEBI3¡Ë¤äIL-12p35¤¬¥Î¥Ã¥¯¥¢¥¦¥È¤µ¤ì¤¿¥Þ¥¦¥¹¤ÎÀºÁã¤Ë, ¥ê¥ó¥Ñµå¤Î¿»½á¤¬´Ñ»¡¤µ¤ì¤Æ¤¤¤ë*13¡£
¤½¤Î¤Û¤«¤Ë¤âÍÍ¡¹¤Ê¥µ¥¤¥È¥«¥¤¥ó¤¬ÀºÁã¤Î¡ÖÌÈ±ÖÆÃ¸¢¡×¤òô¤Ã¤Æ¤¤¤ë¤³¤È¤¬Í½Â¬¤µ¤ì¤ë.
ÉÂÍý½ê¸« †
Æù´ã½ê¸«; âдÝŦ½Ð½Ñ¤ÎɸËܤǤÏø³ì¿§, ³¥¿§¤¢¤ë¤¤¤ÏÇò¿§¤Î¶³¦ÌÀÎÆ¤Ê¼ðáî. ¿ô¥ß¥ê¤«¤é16cm¤Þ¤Ç¤Î¥µ¥¤¥º. 50%¤Î¾ÉÎã¤Ç¤Ï, ÇòËì(tunica albuginea)¤òÀüÄ̤·¤ÆÁý¿£¤·¤Æ¤¤¤ë. ¿¤¯¤Î¾ÉÎã¤ÇÀºÁã¾åÂΤ¬¿¯½±¤µ¤ì¤Æ¤¤¤ë. ¾®¿ôÎã¤ÇÀºº÷¤¬¿¯¤µ¤ì¤ë.
¸÷¸²½ê¸«; ¥ê¥ó¥Ñ¼ð¤Ë¤è¤ê, ¾¯¤Ê¤¯¤È¤â°ìÉô¤ÎÎΰè¤ÎÀººÙ´É¤¬¾Ã¼º¤¹¤ë. Ëö¾¿¤ÎÎΰè¤Ç¤ÏÀººÙ´É¤Î´Ö¼Á¤Ë¥ê¥ó¥Ñ¼ðºÙ˦¤¬¿»½á¤¹¤ë. ¤Û¤È¤ó¤É¤Î¾ì¹ç¡¢¼ðáçºÙ˦¤ÏÀººÙ´É¤Ë¿¯Æþ, ÀººÙ´É¤Î¼þÊÕ¤òÀê¤á¡¢À¸¿£ºÙ˦¤È¥»¥ë¥È¥êºÙ˦¤òÃæ±û¤ËÊѰ̤µ¤»¤ë¤«, ¤Þ¤¿¤ÏÀººÙ´É¤ò´°Á´¤ËÀêµò¤·¤Æ¤·¤Þ¤¦.
1/3¤Î¾ÉÎã¤Ç¤Ï¹Å²½Áü¤ò¼¨¤¹.
¥ê¥ó¥Ñ¼ðÁÈ¿¥·¿ †
- primary testicular lymphoma¤Î¤Û¤È¤ó¤ÉÁ´¤Æ¤¬DLBCL¤ÎÁÈ¿¥·¿.¡¡Â¿¤¯¤Ï, centroblasts¤«¤é¤Ê¤ë¤¬, immunoblast¤ä¿ʬÍճˤò¤â¤Ä¥ê¥ó¥Ñµå¤«¤é¤Ê¤ëÎã¤â¤¢¤ë.
°ìÉô¤ÎÎã¤Ç¤Ï, ¼ðáçÀßÉ˦·ÁÀ®¤ò¤â¤ÄÎΰ褬¤ï¤º¤«¤Ëǧ¤á¤é¤ì¤ë.
- ÌȱÖÀ÷¿§¤Ç¤Ï, 90%¶á¤¯¤¬non germinal-center B-cel¤Îphenotype¤Ë¤Ê¤ê, MIB-1 LI¤Ïhigh¤Ç¤¢¤ë.
- ¥ê¥ó¥Ñ¼ðºÙ˦¤Ïpan B-cell¹³¸¶ÍÛÀ. ¤Þ¤¿CD10, BCL6¤¬ÍÛÀ(¤³¤ì¤Ç¤Ï, non GC¤È¤Ï¤¤¤¨¤Ê¤¤¤Î¤Ç¤Ï¡©)¤È¤Ê¤ë. ¤·¤«¤·Åµ·¿Îã¤Ï,BCL2±¢À. ¤·¤«¤·BCL2ÍÛÀ¤Î¾ÉÎã¤â¿¤¯¤ß¤é¤ì¤ë. ¤½¤Î¾ì¹ç¤Ë¤â,BCL2°äÅÁ»Ò¤ÎºÆ¹½À®¤Ï¸¡½Ð¤µ¤ì¤Ê¤¤.*14
- DLBCL¤Ï¹âÅÙ¤Ësomatic hypermutation¤ò¼¨¤·, HLAȯ¸½¤ò¾Ã¼º¤·¤Æ¤¤¤ë. ¤³¤Î¤¿¤á, ¤ª¤½¤é¤¯ÌȱֲóÈò¤ò½õŤ·¤Æ¤¤¤ë¤È¹Í¤¨¤é¤ì¤ë.
- ¤³¤Î¥ê¥ó¥Ñ¼ð¤Ï NF¦ÊB¤ÈPI3K·ÐÏ©³èÀ²½¤¬´ØÍ¿¤·¤Æ¤ª¤ê, ¥ê¥ó»À²½STAT3, chronic active B-cell signal¤¬¾åÊýÀ©¸æ¤µ¤ì¤Æ¤¤¤ë. CXCR4¤Ï²á¾êȯ¸½¤¹¤ë.
- ¤Û¤È¤ó¤É¤ÎÎã¤Ç, MYD88ÊѰۤ¬¸¡½Ð¤µ¤ì¤ë. 21ºÐ¤«, ¤è¤ê¼ã¤¤´µ¼Ô¤µ¤ó¤Ç¤Ï, DLBCL¤¬Ã±ÆÈ¤ÇȯÀ¸¤¹¤ë¤³¤È¤Ï¤Þ¤ì.
¾®»ù¤ÎÀºÁã¥ê¥ó¥Ñ¼ð¤ÇºÇ¤â¿¤¤¤â¤Î¤Ï, Burkitt's lymphoma¤Ç, ŵ·¿Åª¤Êstarry skyÁÈ¿¥Áü¤ò¼¨¤¹.
primary testicular follicular lymphoma¤Ï¤Þ¤ì. ȯ¾ÉÎã¤Ç¤Ï, ¿¤¯¤¬¸Â¶ÉÀ¤ÎßÉ˦À¥ê¥ó¥Ñ¼ð, grade2¤¢¤ë¤¤¤Ï3a¤Ç¤¢¤ë.´öÎ㤫¤Ï, DLBCL¤Îminor component¤¬Ç§¤á¤é¤ì¤ë¤¬, minor component¤Î¸ºß¤Ïͽ¸åÉÔÎɤȤϴØÏ¢¤·¤Ê¤¤.
¤ï¤º¤«¤ÊÎã¤Ë¤ª¤¤¤Æ MALT lymphoma, peripheral T-cell lymphoma NOS, anaplastic large-cell lymphoma, T-lymphoblastic lymphoma¤¬Êó¹ð¤µ¤ì¤Æ¤¤¤ë.*15*16
(MALT lymphoma¤Ë¤Ä¤¤¤Æ¤Ï, high-grade lymphoma¤ÎÉôʬ¤ËMALT lymphomaÁÈ¿¥¤òǧ¤á¤ë¾ÉÎã¤Î¤è¤¦¤Ç¤¢¤ë*17*18)
1998ǯ¤Î²òÀϤǤÏ, ÀºÁãDLBCL¤Ï¥ê¥ó¥ÑÀáDLBCL¤È¤¤¤¯¤Ä¤«¤Îʬ»ÒÀ¸Êª³ØÅªÆÃħ¤¬°Û¤Ê¤ë¥µ¥Ö¥»¥Ã¥È¤Ç¤¢¤ê, ÁÈ¿¥³ØÅª¤ª¤è¤Óʬ»ÒÀ¸Êª³ØÅª½ê¸«¤¬MALT lymphoma¤Î¤â¤Î¤ÈÁê»÷¤·¤Æ¤¤¤ë¤È¤¹¤ëʸ¸¥¤¬¤¢¤ë. *19
Extranodal NK/T-cell lymphoma, nasal type¤¬âдݤËȯ¾É¤¹¤ë. ¹âÅÙ¿¯½±À, CD56ÍÛÀ, ºÙ˦¾ã³²Àðùγ¥¿¥ó¥Ñ¥¯ÍÛÀ, EBVÍÛÀ¤Çͽ¸åÉÔÎɤΥê¥ó¥Ñ¼ð¤Ç¤¢¤ë.
¥¹¥Æ¡¼¥¸, ¼£ÎŤª¤è¤Óͽ¸å †
âдݤò¿¯½±¤¹¤ë°À¥ê¥ó¥Ñ¼ð´µ¼Ô¤µ¤ó¤Î70-80%¤Ï¸Â¶ÉÀ¼À´µ¤Ç¤¢¤ê, Ann Abor stage¤ÏI¤¢¤ë¤¤¤Ï¶¤Ç¤¢¤ë*20*21 *22Ⱦ¿ô°Ê¾å¤Ïstage I¤Ë¤Ê¤ë.*23
âдÝDLBCL¤Ï°ìÈ̤Ëͽ¸åÉÔÎɤȹͤ¨¤é¤ì, ¼£ÎŤ¬¤¤¤¯¤é¤«¿ÊÊ⤷¤¿¸½ºß¤Ç¤â, ´µ¼Ô¤µ¤ó¤ÎÀ¸Â¸Ãæ±ûÃͤÏ6¥õ·î¤Ë²á¤®¤º, ²þÁ±¤Î;ÃϤ¬Â礤¤.*24
ºÆÈ¯»þ¤Ë¤ÏCNS¤Ø¤ÎȯÀ¸¤¬ºÇ¤â¿¤¯, ÂЦ¤ÎâдÝ, ¹ü, ÇÙ, ÈéÉæ, ¥ï¥ë¥À¥¤¥¨¥ëÎØ, ´Î¡, ¿Õ¡, ¤½¤Î¾¤Ø¤ÎºÆÈ¯¤â¤¢¤ë.
¥ê¥ó¥ÑÀá¤Ë¤âºÆÈ¯¤¬¤¢¤ê¤¨¤ë. *24*25*26
Diffuse large B-cell lymphoma †
Case01; 80 yo male. 20ÆüÁ°¤³¤í¤è¤ê±¢Ç¹¼ðÂç¤Ëµ¤¤Å¤¯. 5Æü¸å, âдݤÎÄˤ߽и½.¡¡ÍâÆüµßµÞ³°Íè¼õ¿Ç. º¸ÀºÁã¤Ï·ÜÍñÂç¤Ë¼ðÂç. ¼£ÎŤˤè¤ë²þÁ±¤Ê¤¯¹â°ÌÀºÁãŦ½Ð½Ñ¤¬»Ü¹Ô¤µ¤ì¤ë.
ÉÂÍýÁÈ¿¥½ê¸«
¼ðáçÆâ¤Ë²õ»à¤¬Ç§¤á¤é¤ì¤ë. °Û·¿¥ê¥ó¥Ñµå¤ÎÌ©¤ÊÁý¿£¤Ë¤è¤êÀººÙ´É¤Ï¾Ã¼º¤·¤Æ¤¤¤ë.¡¡
¼ðáçºÙ˦¤Ïcentroblastic cells. mitosis¤äapoptosis¤¬Â¿¤¤.
Diffuse large B-cell lymphoma of the lt. testis, 6.0x5.0x4.5cm in size.
Case02¡¡71yo male.¡¡Î¾Â¦ÀºÁã¼ðÂç¤Ëµ¤¤Å¤¯. ÀºÁã¤Ïξ¦¤È¤â¤Ë·ÚÅÙ¼ðÂ礷¹Å¤¯, °µÄˤϤʤ¤. LDH 242 U/L¤È·ÚÅÙÁý²Ã. CT, MRI¤Ç˵ÂçÆ°Ì®¥ê¥ó¥ÑÀá¤Î¼ðÂ礢¤ê.
ÉÂÍýÁÈ¿¥½ê¸«
lt. testicular tumor
rt. testicular tumor
ÀººÙ´É¤Ï¿»½á¤Ë¤è¤ê°à½Ì, ¾Ã¼º. ¤Ó¤Þ¤óÀ¤Ëcentroblasts/immunoblasts¤ÎÁý¿£¤¬Ç§¤á¤é¤ì¤ë. ¼ðáçºÙ˦´Ö¤Ë·ÚÅÙ¤ÎÀþ°Ý²½¤¬¤¢¤ë.
ξ¦ÀÀºÁã¥ê¥ó¥Ñ¼ð¤Ï, Ìȱ֥°¥í¥Ö¥ê¥ó·Úº¿°äÅÁ»ÒºÆÊÔÀ®¤Ë¤ª¤¤¤Æ°ì´Ó¤·¤¿¥¯¥í¡¼¥óÀ¤ò¼¨¤·, ÀºÁã¤Ë¤ª¤¤¤Æ¥ê¥ó¥Ñ¼ð¤ÎÀøºßŪÇżï¤Ë¤è¤ë¤â¤Î¤Ç¤¢¤ê, ¸¶È¯À¤Îξ¦ÀÀºÁã¥ê¥ó¥Ñ¼ð¤Ç¤Ï¤Ê¤¤¤È¿ä»¡¤µ¤ì¤Æ¤¤¤ë.*27
Case 03
ÉÂÍýÁÈ¿¥½ê¸«
Áý¿£Áã¤Ç¤ÏÀººÙ´É¤Ï¾Ã¼º, °à½Ì. ¼ðáç¶³¦Éô¤Ç¤Î¿»½á½ê¸«¤¬¤¢¤ë.
Extranodal NK/T-cell lymphoma, nasal type of the testis †
ÉÂÍýÁÈ¿¥½ê¸«
¾®¥ê¥ó¥Ñµå¤ÈÆ±ÄøÅÙ¤«1.5Çܤ¯¤é¤¤¤Î¥µ¥¤¥º, round/ convoluted nuclei¤ò¤â¤Ä¥ê¥ó¥Ñµå¤¬¥·¡¼¥È¾õÌ©¤ËÁý¿£¤¹¤ë. ³Ë¥¯¥í¥Þ¥Á¥ó¤ÏÁƤÇ, ³Ë¾®ÂΤ¬Ç§¤á¤é¤ì¤ë³Ë¤â¤¢¤ë.
DLBCL¤È¤ÏºÙ˦¤ÎÂ礤µ¤äºÙ˦½ê¸«¤¬°Û¤Ê¤Ã¤Æ¤¤¤ë. ÀººÙ´É¤Ø¤Î¿»½á, Àêµò½ê¸«¤¬¤¢¤ë.
ÌȱÖÀ÷¿§
Extranodal NK/T-cell lymphoma, nasal type of the testis
Case; Diffuse medium-sized B-cell lymphoma with germinal center phenotype †
Nmz-case 55yo male º¸âдݤμðáî¤Ëµ¤¤Å¤¼õ¿Ç.
ÀººÙ´É¤Î¿¤¯¤¬¥¹¥Ú¥¢¤µ¤ì, ´Ö¼Á¤Ëlymphoid cells¤¬Ì©¤Ë¿»½á¤·¤Æ¤¤¤ë. ¤ï¤º¤«¤ÊÀººÙ´É¤Ë¿»½á¤¬Ç§¤á¤é¤ì°à½Ì¤äÇ˲õÁü¤¬Ç§¤á¤é¤ì¤ë.
Îà±ß·Á/¿ÎÇ·Á¤Î³Ë¤ò¤â¤ÄN/CÈæÂç¤ÎºÙ˦. ÁÆÂç¤Ê¥¯¥í¥Þ¥Á¥ó¤¬Áý²Ã, ³Ë¾®ÂΤÏÉÔÌÀÎÆ.
DLBCL¤Ëǧ¤á¤é¤ì¤ëcentroblasts/ immunoblasts¤ÎºÙ˦½ê¸«¤È°Û¤Ê¤ë.
LCA(CD45)+, CD20+(focal¤Ë±¢À), CD79a+, PAX5+, CD5-, CD10+, BCL6+¤¬Â¿¤¤, MUM1-, BCL2+, cyclinD1-, MIB1 LI; very high(>80%). EBER-ISH-.
IGH; clonal band+ (BIOMED2, FR1 and FR2). MYD88L265P¤ÏAS-specific PCR¤Ç±¢À.
Molecular ¤Ë¤âcommon type¤Îtesticular DLBCL¤È¤Ï°Û¤Ê¤Ã¤Æ¤¤¤ë¤è¤¦¤Ç¤¢¤ë.