肿瘤细胞治疗研究
英文原题：The case of T-ALL presenting with NK phenotype after COVID-19 vaccination.
NK-淋巴母细胞白血病/淋巴瘤（NK-LL）是一种由自然杀伤（NK）前体细胞组成的极为罕见的造血系统肿瘤，其谱系与T细胞存在重叠，导致诊断具有挑战性。
NK淋巴母细胞白血病/淋巴瘤（NK-LL）是一种极为罕见的由自然杀伤（NK）前体细胞组成的造血系统肿瘤，其谱系与T细胞存在重叠，导致诊断困难。对于癌症患者（包括造血系统肿瘤患者）等有病情加重风险的人群，推荐接种COVID-19疫苗。我们报告一例55岁男性，在接种COVID-19疫苗后出现颈部淋巴结肿大。由于实验室检查发现异型淋巴细胞伴IL-2R升高，怀疑血液系统恶性肿瘤。骨髓和淋巴结流式细胞术显示肿瘤细胞CD7、CD56、cyCD3和末端脱氧核苷酸转移酶（TdT）阳性。组织病理学检查显示肿瘤细胞呈单一性增殖，骨髓中细胞CD3和TdT阳性，淋巴结中细胞CD3、TdT和CD56阳性。尽管这些发现提示NK-LL，但骨髓中通过Southern印迹杂交检测到克隆性T细胞受体（TCR）β基因重排。TCRβ重排最终导致诊断为T细胞淋巴母细胞白血病（T-ALL）。COVID-19疫苗接种与癌变之间的因果关系尚不明确，需要研究更多病例以阐明这两个因素之间的关系。
NK-lymphoblastic leukemia/lymphoma (NK-LL) is an extremely rare hematopoietic tumor consisting of natural killer (NK) precursor cells, and their lineage overlaps with T-cells, making it challenging to diagnose. COVID-19 vaccination is recommended for people with a risk of aggravation such as cancer-bearing patients, including hematopoietic tumors. We present a 55-year-old man who had cervical lymph node swelling post vaccination for COVID-19. Hematological malignancy was suspected due to the presence of atypical lymphoid cells with an elevated IL-2R in laboratory data. Tumor cells were positive for CD7, CD56, cyCD3, and terminal deoxynucleotidyl transferase (TdT) evidenced through flow cytometry of the bone marrow and the lymph node. The histopathological findings showed monotonous tumor cell proliferation, the cells being positive for CD3 and TdT in the bone marrow and they were positive for CD3, TdT, and CD56 in lymph node. Even though these findings suggested NK-LL, clonal T-cell receptor (TCR) β gene rearrangement by Southern blot hybridization was observed in the bone marrow. TCRβ rearrangement led to the final diagnosis of T-cell lymphoblastic leukemia (T-ALL). The causal relationship between COVID-19 vaccination and carcinogenesis is not clear, and more cases need to be studied in order to elucidate the relationship between the two factors.
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