Elgin J, Phillips J G, Reddy V V, Gibbs P O, Listinsky C M
Department of Pathology, Russell Hospital, Alexander City, AL, USA.
Ann Diagn Pathol. 1999 Oct;3(5):263-75. doi: 10.1016/s1092-9134(99)80021-5.
Immunoperoxidase markers are useful and often essential in distinguishing among lymphocyte-predominant Hodgkin's lymphoma, T-cell-rich B-cell lymphoma, and lymphocyte-rich classic Hodgkin's lymphoma. However, it is becoming increasingly clear that these "entities" are closely related clonal B-lineage neoplasms that may intertransform and/or coexist. We hypothesized that, just as there are cases with morphologic overlap, there would also be immunophenotypic overlap that would be found when a series of such cases is studied in detail. Eight cases of lymphocyte predominant Hodgkin's lymphoma, eight cases of lymphocyte-rich classic Hodgkin's lymphoma, seven cases of T-cell-rich B-cell lymphoma, and four cases of large B-cell lymphoma with focal features of T-cell-rich B-cell lymphoma were examined by the immunoperoxidase technique for expression of CD3, CD15, CD30, CD20, CD57, epithelial membrane antigen, and Epstein-Barr virus latent membrane protein (EBV LMP). All eight of the lymphocyte-predominant Hodgkin's lymphoma cases had CD20+ lymphocytic and histiocytic cells and CD57+ rosettes; however, in two cases, occasional lymphocytic and histiocytic cells were also weakly positive for CD15, CD30, and EBV LMP. Among the eight lymphocyte-rich classic Hodgkin's lymphoma cases, CD15+ Reed-Sternberg (R-S) cells were found in seven; however, in three of these cases rare rosettes of CD57+ cells surrounded the R-S or lacunar cells. In one case of large B-cell lymphoma the malignant cells resembled R-S cells and were CD20+, EBV LMP+, CD30+, CD15-, and surrounded by rosettes of CD57+ T cells. The majority of the cases exhibited the "expected" immunophenotypic patterns; however, the exceptional cases that were found serve to confirm the interrelationship among these clonal B-lineage neoplasms.
免疫过氧化物酶标记物在鉴别淋巴细胞为主型霍奇金淋巴瘤、富于T细胞的B细胞淋巴瘤和富于淋巴细胞的经典型霍奇金淋巴瘤中很有用，且常常是必不可少的。然而，越来越清楚的是，这些“实体”是密切相关的克隆性B细胞系肿瘤，它们可能相互转化和/或共存。我们推测，正如存在形态学重叠的病例一样，当对一系列此类病例进行详细研究时，也会发现免疫表型重叠。通过免疫过氧化物酶技术检测了8例淋巴细胞为主型霍奇金淋巴瘤、8例富于淋巴细胞的经典型霍奇金淋巴瘤、7例富于T细胞的B细胞淋巴瘤以及4例具有富于T细胞的B细胞淋巴瘤局灶特征的大B细胞淋巴瘤中CD3、CD15、CD30、CD20、CD57、上皮膜抗原和爱泼斯坦-巴尔病毒潜伏膜蛋白（EBV LMP）的表达。所有8例淋巴细胞为主型霍奇金淋巴瘤病例均有CD20+淋巴细胞和组织细胞以及CD57+玫瑰花结；然而，在2例病例中，偶尔的淋巴细胞和组织细胞对CD15、CD30和EBV LMP也呈弱阳性。在8例富于淋巴细胞的经典型霍奇金淋巴瘤病例中，7例发现有CD15+里德-斯腾伯格（R-S）细胞；然而，在其中3例病例中，罕见的CD57+细胞玫瑰花环绕R-S或陷窝细胞。在1例大B细胞淋巴瘤病例中，恶性细胞类似于R-S细胞，CD20+、EBV LMP+、CD30+、CD15-，并被CD57+T细胞玫瑰花环绕。大多数病例表现出“预期”的免疫表型模式；然而，发现的例外病例证实了这些克隆性B细胞系肿瘤之间的相互关系。
