Burkittov lymfóm s nezvyčajnou granulomatóznou reakciou. Kazuistika
:
A. Janegová 1; P. Janega 1,2; D. Ilenčíková 3; P. Babál 1
:
Department of Pathology, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic
1; Institute of Normal and Pathological Physiology, Slovak Academy of Sciences, Bratislava, Slovak Republic
2; National Cancer Institute, Department of Clinical Genetics, Bratislava, Slovak Republic
3
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Čes.-slov. Patol., 47, 2011, No. 1, p. 19-22
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Original Article
Výskyt granulomatóznej reakcie sprevádzajúcej rôzne druhy nádorov bol už v minulosti opísaný. Spomedzi lymfoproliferatívnych chorôb, vykazuje tvorbu granulómov predovšetkým Hodkinov lymfóm a T-bunkové non-Hodkinove lymfómy (NHL). V B-bunkových NHL, ako je Burkittov lymfóm, sú granulomatózne reakcie zriedkavé. V tejto práci predstavujeme prípad sporadického Burkittovho lymfómu sprevádzaného tvorbou granulómov pripomínajúcich sarkoidózu. Klinické, laboratórne, ani histologické vyšetrenie nepreukázalo prítomnosť infekčných agens, resp. nesvedčilo pre diagnózu sarkoidózy. In situ hybridizáciou a polymerázovou reťazovou reakciou sa v tkanive dokázala prítomnosť Epstein-Barrovej vírusu (EBV). Negativita imunohistochemicky stanovovaného vírusového latentného membránového proteínu 1 (LMP1) spolu s predchádzajúcimi vyšetreniami svedčí v tomto prípade pre typ I latentnej EBV infekcie. Cytogenetická analýza s použitím fluorescenčnej in situ hybridizácie odhalila mutáciu génu c-MYC spolu s naznačenou fúziou MYC/IgL. Absencia EBV v histiocytoch podporuje skôr reaktívny charakter granulomatóznej reakcie na nádorový proces. Biologický a prognostický význam vzniku týchto granulómov sprevádzajúcich Burkittov lymfóm a úloha EBV infekcie v tomto vzťahu zostáva však nejasná.
Kľúčové slová:
Burkittov lymfóm – granulomatózna reakcia - Epstein-Barrovej virus - EBV
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