A case of a multilobated B-cell lymphoma, probably derived from a parapancreatic lymph node. Cytologic and electron microscopic features, and gene analysis.

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  • Ｍｕｌｔｉｌｏｂａｔｅｄ　Ｂ細胞性リンパ腫の１例　　腹水細胞像，および遺伝子解析と電子顕微鏡像
  • Cytologic and electron microscopic features, and gene analysis
  • 腹水細胞像, および遺伝子解析と電子顕微鏡像

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Background: Multilobated B-cell lymphoma (MLBL) is rare. We describe a case probably derived from a parapancreatic lymph node.<BR>Case: A 37-year old Japanese man was hospitalized with suspected pancreatic cancer. Ascites cytology showed abundant medium to large atypical lymphocytes with marked nuclear indentation resembling a flower. More than half of the tumor cells had 3 or more lobed nuclei.<BR>At autopsy, lymphoma cells immunohistochemically proven to have a B-cell phenotype were mainly found proliferating in parapancreatic lymph nodes with invasion to multiple organs. These finding confirmed this case to be MLBL, probably derived from a parapancreatic lymph node. Using ascites material and tumor tissue obtained at autopsy, immunoglobulin heavy chain gene rearrangement analysis demonstrated a single band, indicating monoclonal proliferation of B-cell lymphoma cells. Electron microscopy showed rough surface endplasmic reticulum, mitochondria, fat droplets, and microvilli-like structures in tumor cells.<BR>Conclusions: It is important in diagnosing MLBL to detect characteristic nuclear findings. Immunoglobulin gene analysis and electron microscopy aid in such diagnosis.

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