Woda B A, Knowles D M
Cancer. 1979 Jan;43(1):303-7. doi: 10.1002/1097-0142(197901)43:1<303::aid-cncr2820430144>3.0.co;2-y.
The patient described here had a nodular, poorly differentiated lymphocytic lymphoma associated with a serum monoclonal protein, IgG lambda. Following a three year period of radiation-induced clinical remission she developed generalized diffuse histiocytic lymphoma. Direct immunoperoxidase staining of the tissue sections demonstrated that the neoplastic cells of each biopsy only contained IgG lambda immunoglobulin, identical to the serum monoclonal protein. This is presumptive evidence that these two histopathologically distinctive malignant lymphomas, occurring consecutively in the same patient, were responsible for the synthesis and secretion of the same serum M component. This strongly suggests that both lymphoid neoplasms arose from the same malignant clone. The results 1) confirm the light microscopic observation that nodular lymphocytic lymphoma may progress to diffuse histiocytic lymphoma and 2) offer further evidence that histiocytic lymphomas arising in patients with previous B cell malignancies are most probably related to the original B cell proliferation and do not represent the emergence of a second, separate malignant clone.
此处描述的患者患有结节性、低分化淋巴细胞淋巴瘤，并伴有血清单克隆蛋白IgG λ。经过三年的放射诱导临床缓解期后，她发展为全身性弥漫性组织细胞淋巴瘤。组织切片的直接免疫过氧化物酶染色显示，每次活检的肿瘤细胞仅含有IgG λ免疫球蛋白，与血清单克隆蛋白相同。这是推测性证据，表明这两种在同一患者中相继发生的组织病理学上不同的恶性淋巴瘤，负责合成和分泌相同的血清M成分。这强烈提示这两种淋巴瘤均起源于同一恶性克隆。结果1）证实了光镜观察结果，即结节性淋巴细胞淋巴瘤可能进展为弥漫性组织细胞淋巴瘤；2）进一步证明，先前患有B细胞恶性肿瘤的患者中出现的组织细胞淋巴瘤很可能与原始B细胞增殖有关，并非代表第二个独立恶性克隆的出现。
