A 58-year-old woman underwent emergency surgical resection of the small intestine for intussusception as diagnosed at our hospital. Histopathological diagnosis of the resected specimen of the ileum was amyloid light chain (AL) amyloidosis. The colonoscopy after the surgical resection and following histopathological analysis of the biopsied specimens of the colon revealed follicular lymphoma (FL) grade 1 with plasmacytic differentiation. Histological findings of these ileal and colonic lesions were characteristic. In the ileum, CD10-positive lymphoid follicles and CD38-positive interfollicular plasma cell infiltration into villi were detected. The amyloid deposition was localized to the ileum and was adjacent to lymphoid follicles and interfollicular plasma cells. Furthermore, fluorescence in situ hybridization (FISH) for paraffin-embedded tissue sections (tissue-FISH) revealed that both the B cells in follicular lesions and the interfollicular plasma cells showed IGH/BCL2 fusion signals, which means the interfollicular plasma cells were originated from the differentiated neoplastic follicular B cells. The patient was treated with six courses of lymphoma chemotherapy and attained complete remission without any symptoms associated with amyloidosis. Further case analyses are needed to clarify the clinicopathological findings and to establish therapeutic strategy of AL amyloidosis associated with FL and FL with plasmacytic differentiation.

中文翻译：

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一例淀粉样变性伴滤泡性淋巴瘤伴浆细胞分化。

根据我们医院的诊断，一名58岁的妇女因肠套叠接受了小肠紧急外科手术切除。回肠切除标本的组织病理学诊断为淀粉样蛋白轻链（AL）淀粉样变性。手术切除后的结肠镜检查以及对结肠活检标本的组织病理学分析显示，滤泡性淋巴瘤（FL）为1级，具有浆细胞分化。这些回肠和结肠病变的组织学发现是特征性的。在回肠中，检测到CD10阳性淋巴滤泡和CD38阳性小泡间浆细胞浸润到绒毛中。淀粉样蛋白沉积位于回肠，并与淋巴滤泡和小泡间浆细胞相邻。此外，石蜡包埋的组织切片的荧光原位杂交（FISH）显示卵泡病变中的B细胞和小泡间浆细胞均显示IGH / BCL2融合信号，这意味着小泡间浆细胞起源于分化的肿瘤滤泡性B细胞。该患者接受了六个疗程的淋巴瘤化学疗法治疗，完全缓解，没有任何淀粉样变性病相关症状。需要进一步的病例分析以阐明临床病理结果，并建立与FL和伴浆细胞分化的FL相关的AL淀粉样变性的治疗策略。这意味着小泡间浆细胞起源于分化的赘生性滤泡B细胞。该患者接受了六个疗程的淋巴瘤化学疗法治疗，完全缓解，没有任何淀粉样变性病相关症状。需要进一步的病例分析以阐明临床病理结果，并建立与FL和伴浆细胞分化的FL相关的AL淀粉样变性的治疗策略。这意味着小泡间浆细胞起源于分化的赘生性滤泡B细胞。该患者接受了六个疗程的淋巴瘤化学疗法治疗，完全缓解，没有任何淀粉样变性病相关症状。需要进一步的病例分析以阐明临床病理结果，并建立与FL和伴浆细胞分化的FL相关的AL淀粉样变性的治疗策略。