A Rare Case of Signet Ring Cell Lymphoma and Review of the Literature

Abstract

Signet ring cell lymphoma (SRCL) is a non-Hodgkin's lymphoma with a very rare variant. Although this morphology is frequently seen in follicular lymphoma, it can also be observed in the group of diffuse large B-cell lymphomas. A seventy-six year old woman with known diagnosis of gastric adenocarcinoma, tubular type, moderately differentiate presented with a mesenteric lymphadenopathy with high FDG uptake (SUVmax: 21.3) in PET/CT during follow-up. A tru-cut biopsy was performed for histopathological diagnosis. Diffuse infiltrative singet ring neoplastic cells showed negativity for PanCK, CK7, CK20, S100, SMA, calretinin and vimentin. The panel was then expanded to include SRCL, a rare variant of lymphoma. Additional immunohistochemical evaluation revealed positivity for CD20, CD19, PAX-5 and Bcl-2. Ki-67 proliferation index was about 80%. CD3, CD30, Myc, Bcl-6, ALK, Cyclin-D1, CD23, CD10, CD21, and MUM-1 were negative. EBER was also negative by chromogen in situ hybridization (CISH). Based on these data, diffuse large B-cell lymphoma (DLBCL) was considered. We herein reported a case of signet ring cell lymphoma discussed its clinical and morphological features with regard to the literature.

Keywords

• Signet ring cell
• Lymphoma
• Diffuse Large B-Cell Lymphoma
• Post transplant

Nadir Bir Taşlı Yüzük Hücreli Lenfoma Olgusu ve Literatürün Gözden Geçirilmesi

Abstract

Taşlı yüzük hücreli lenfoma, Hodgkin dışı lenfomaların oldukça nadir görülen bir varyantıdır. Bu morfoloji sıklıkla foliküler lenfomada görülmekle birlikte diffüz büyük B hücreli lenfomalar grubunda da görülebilmektedir. Bilinen tübüler tip mide adenokarsinomu tanısı olan 76 yaşında kadın hasta, takip sırasında PET/BT'de FDG tutulumu yüksek (SUVmax: 21,3) mezenterik lenfadenopati ile başvurdu. Histopatolojik tanı için tru-cut biyopsi yapıldı. Diffüz infiltrasyonlu taşlı yüzük görünümündeki neoplastik hücreler PanCK, CK7, CK20, S100, SMA, kalretinin ve vimentin için negatiflik gösterdi. Panel daha sonra nadir bir lenfoma çeşidi olan SRCL'yi içerecek şekilde genişletildi. Ek immünhistokimyasal incelemede CD20, CD19, PAX-5, Bcl-2'nin pozitif olduğu ve Ki-67 proliferasyon indeksinin %80 civarında olduğu görüldü. CD3, CD30, Myc, Bcl-6, ALK, Cyclin-D1, CD23, CD10, CD21, MUM-1 negatifti. EBER, kromojen in situ hibridizasyon (CISH) ayrıca negatifti. Bu verilere dayanarak diffüz büyük B hücreli lenfoma (DLBCL) düşünüldü. Burada taşlı yüzük hücreli bir lenfoma olgusu sunulmuş olup morfolojik ve klinik özelliği literatür eşliğinde tartışılmıştır.

Keywords

• Taşlı yüzük hücreli
• Lenfoma
• Diffüz Büyük B Hücreli Lenfoma
• Transplantasyon sonrası

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