Дифференциальная диагностика плоскоклеточного рака и трансформации Рихтера в надгортанной ямке: Морфологические, иммуногистохимические и биопсийные аспекты для получения максимально информативного материала
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| Sprache: | Russisch |
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2025
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| author | Makedonskaia, Sofiia |
| author_facet | Makedonskaia, Sofiia |
| contents | <p>This article discusses a rare and complex case involving the differential diagnosis of a lesion in the epiglottic vallecula, highlighting the challenges in distinguishing between squamous cell carcinoma (SCC) and Richter's transformation (RT), specifically into diffuse large B-cell lymphoma (DLBCL), in a patient with a history of chronic lymphocytic leukemia (CCLL) and mixed lymphocytic-histiocytic lymphoma (MLHL).</p> <p>The patient presented with symptoms concerning for a malignancy in the laryngeal region. Initial biopsies and imaging (PET-CT, MRI, CT) were crucial for localizing the lesion and assessing its metabolic activity. The primary diagnostic challenge lay in the histological and immunohistochemical (IHC) analysis, as both SCC and DLBCL can present with similar morphological features in a poorly differentiated state.</p> <p>Key to the diagnosis were specific IHC markers. For SCC, markers such as p40, p63, and Cytokeratin 5/6 (CK5/6) are typically positive, indicating squamous differentiation. For DLBCL, pan-B-cell markers like CD45, CD20, and CD79a are essential. The presence of both squamous and lymphoid markers, or an ambiguous pattern, would necessitate careful interpretation and potentially further specialized testing.</p> <p>Richter's transformation, a serious complication of CLL, involves the progression of CLL into a more aggressive lymphoma, most commonly DLBCL. This transformation can occur in various sites, including extranodal ones like the epiglottis. The article emphasizes the importance of considering the patient's full medical history, including previous hematological malignancies, when evaluating new lesions.</p> <p>The ultimate diagnosis and distinction between these two aggressive cancers are critical for guiding appropriate treatment strategies and determining the patient's prognosis. This case underscores the need for a multidisciplinary approach involving oncologists, pathologists, hematologists, and otolaryngologists for optimal patient management.</p> |
| format | Recurso digital |
| id | zenodo_https___doi_org_10_5281_zenodo_15881581 |
| institution | Zenodo |
| language | rus |
| publishDate | 2025 |
| publisher | Zenodo |
| record_format | zenodo |
| spellingShingle | Дифференциальная диагностика плоскоклеточного рака и трансформации Рихтера в надгортанной ямке: Морфологические, иммуногистохимические и биопсийные аспекты для получения максимально информативного материала Makedonskaia, Sofiia Oncology Surgical Oncology Carcinoma Carcinoma, Squamous Cell Lymphoma <p>This article discusses a rare and complex case involving the differential diagnosis of a lesion in the epiglottic vallecula, highlighting the challenges in distinguishing between squamous cell carcinoma (SCC) and Richter's transformation (RT), specifically into diffuse large B-cell lymphoma (DLBCL), in a patient with a history of chronic lymphocytic leukemia (CCLL) and mixed lymphocytic-histiocytic lymphoma (MLHL).</p> <p>The patient presented with symptoms concerning for a malignancy in the laryngeal region. Initial biopsies and imaging (PET-CT, MRI, CT) were crucial for localizing the lesion and assessing its metabolic activity. The primary diagnostic challenge lay in the histological and immunohistochemical (IHC) analysis, as both SCC and DLBCL can present with similar morphological features in a poorly differentiated state.</p> <p>Key to the diagnosis were specific IHC markers. For SCC, markers such as p40, p63, and Cytokeratin 5/6 (CK5/6) are typically positive, indicating squamous differentiation. For DLBCL, pan-B-cell markers like CD45, CD20, and CD79a are essential. The presence of both squamous and lymphoid markers, or an ambiguous pattern, would necessitate careful interpretation and potentially further specialized testing.</p> <p>Richter's transformation, a serious complication of CLL, involves the progression of CLL into a more aggressive lymphoma, most commonly DLBCL. This transformation can occur in various sites, including extranodal ones like the epiglottis. The article emphasizes the importance of considering the patient's full medical history, including previous hematological malignancies, when evaluating new lesions.</p> <p>The ultimate diagnosis and distinction between these two aggressive cancers are critical for guiding appropriate treatment strategies and determining the patient's prognosis. This case underscores the need for a multidisciplinary approach involving oncologists, pathologists, hematologists, and otolaryngologists for optimal patient management.</p> |
| title | Дифференциальная диагностика плоскоклеточного рака и трансформации Рихтера в надгортанной ямке: Морфологические, иммуногистохимические и биопсийные аспекты для получения максимально информативного материала |
| topic | Oncology Surgical Oncology Carcinoma Carcinoma, Squamous Cell Lymphoma |
| url | https://doi.org/10.5281/zenodo.15881581 |