Stein H
Immun Infekt. 1976 Apr;4(2):52-69.
A review is given of the new Kiel classification of non-Hodgkin's lymphomas (NHL) and of the findings which led to its development. The Kiel classification of NHL is based on morphological and immunological features shared by normal and neoplastic cells. Therefore, the origin, maturation, and reaction of nonneoplastic T- and B-cells together with their immunological, enzyme-cytochemical and morphological features are discussed first. In the T-cell system T-precursor cells, prothymocytes, T1/T2-cells, and T-immunoblasts can be distinguished on the basis of the given features. The B-system is primarily composed of cells of the two antigen-dependent B-cell reactions, the germinal center reaction, and the plasma cell reaction. These cells can be distinguished both morphologically and through demonstration of the complement receptor in frozen sections. We differentiate the following entities of NHL, divided into six groups for better understanding: 1. lymphocytic lymphomas: chronic lymphocytic leukemia (CLL), prolymphocytic leukemia, hairy cell leukemia, mycosis fungoides, and Sézary syndrome; 2. secretory immunoglobulin-producing lymphomas: plasmacytoma and lymphoplasmacytoid immunocytoma; 3. germinal center cell tumors: centroblastic/centrocytic lymphoma, centrocytic lymphoma, centroblastic lymphoma, Burkitt's lymphoma, and lymphoma of the Burkitt type; 4. lymphoblastic lymphomas: "convoluted cell" type and "unclassified" type; 5. immunoblastic lymphoma; 6. reticulosarcoma. B-cell characteristics are revealed by more than 80% of the NHL, namely by 97% of the cases of CLL, by all secretory immunoglobulin-producing lymphomas, by all germinal center cell tumors, and by most immunoblastic lymphomas. More than 50% of the B-cell tumors are evidently derived from germinal center cells. The following are T-cell tumors: a few rare forms of CLL, mycosis fungoides Sézary syndrome, about 50% of the lymphoblastic lymphomas, and a few immunoblastic lymphomas. It could be shown that the cells of lymphoblastic lymphoma, "convolted cell" type with strong acid phosphatase reactivity have the same features as fetal thymocytes. So far, we have not observed any cases of true reticulosarcoma as described by Roulet and Rappaporti, i.e. tumors of phagocytic reticulum cells. The morphological features which could be defined for the entities distinguished in the Kiel classification of NHL are so characteristic that most of these entities can now be diagnosed on the basis of their histological and cytological pictures alone.
本文综述了非霍奇金淋巴瘤(NHL)的新基尔分类法及其形成依据。NHL的基尔分类法基于正常细胞和肿瘤细胞共有的形态学和免疫学特征。因此,首先讨论非肿瘤性T细胞和B细胞的起源、成熟及反应,以及它们的免疫学、酶细胞化学和形态学特征。在T细胞系统中,可根据特定特征区分T前体细胞、原胸腺细胞、T1/T2细胞和T免疫母细胞。B细胞系统主要由两种抗原依赖性B细胞反应的细胞组成,即生发中心反应细胞和浆细胞反应细胞。这些细胞在形态上以及通过冰冻切片中补体受体的显示均可区分。我们将NHL分为以下几类,为便于理解分为六组:1. 淋巴细胞性淋巴瘤:慢性淋巴细胞白血病(CLL)、原淋巴细胞白血病、毛细胞白血病、蕈样霉菌病和Sezary综合征;2. 分泌免疫球蛋白的淋巴瘤:浆细胞瘤和淋巴浆细胞样免疫细胞瘤;3. 生发中心细胞肿瘤:中心母细胞/中心细胞淋巴瘤、中心细胞淋巴瘤、中心母细胞淋巴瘤、伯基特淋巴瘤和伯基特样淋巴瘤;4. 淋巴母细胞性淋巴瘤:“卷曲细胞”型和“未分类”型;5. 免疫母细胞性淋巴瘤;6. 网状细胞肉瘤。超过80%的NHL显示B细胞特征,即97%的CLL病例、所有分泌免疫球蛋白的淋巴瘤、所有生发中心细胞肿瘤以及大多数免疫母细胞性淋巴瘤。超过50%的B细胞肿瘤明显源自生发中心细胞。以下是T细胞肿瘤:少数罕见形式的CLL、蕈样霉菌病Sezary综合征、约50%的淋巴母细胞性淋巴瘤以及少数免疫母细胞性淋巴瘤。研究表明,具有强酸性磷酸酶反应性的“卷曲细胞”型淋巴母细胞性淋巴瘤细胞与胎儿胸腺细胞具有相同特征。到目前为止,我们尚未观察到Roulet和Rappaporti所描述的真正的网状细胞肉瘤病例,即吞噬性网状细胞肿瘤。在NHL的基尔分类法中所区分的各类肿瘤的形态学特征非常典型,以至于现在大多数此类肿瘤仅根据其组织学和细胞学图像即可诊断。