Chuang S S, Lin C N, Li C Y
Department of Pathology, Chi-Mei Foundation Hospital, Tainan, Taiwan.
Cancer. 2000 Oct 1;89(7):1586-92.
The purpose of the current study was to determine the distribution and relative frequency of each subtype of malignant lymphoma in southern Taiwan according to the revised European-American classification of lymphoid neoplasms (REAL).
The pathology files of a regional hospital in southern Taiwan for 1989-1998 were searched for malignant lymphoma, lymphoproliferative disorder, and Hodgkin disease (HD). The results of light microscopy, immunohistochemistry, and in situ hybridization for Epstein-Barr virus-encoded RNA (EBER) were correlated with clinical findings, and all cases were classified according to REAL.
A total of 205 cases were analyzed retrospectively. There were 197 cases (96.1%) of non-Hodgkin lymphoma (NHL) and 8 cases (3. 9%) of HD. Among the 197 NHL cases, 161 (81.7%) were of B-cell lineage and 36 (18.3%) were of T-/natural killer cell lineage. Diffuse large B-cell lymphoma, extranodal marginal zone lymphoma, and follicular lymphoma were the most common B-cell subtypes and represented 47.2%, 19.3%, and 6.1%, respectively, of all NHL cases. Among the 36 cases of T-/natural killer cell lineage, unspecified peripheral T-cell lymphoma (8.6%), T-/natural killer cell lymphoma (angiocentric lymphoma) (4.1%), and anaplastic large cell lymphoma (3.6%) were the most common subtypes. Seven of eight T-/natural killer cell lymphoma cases were positive for EBER. The eight cases of HD were classified as lymphocyte-rich classic (two cases), nodular sclerosis (two cases), and mixed cellularity (four cases) subtypes. Three of these eight cases were positive for EBER.
To the authors' knowledge this study is the first in Taiwan using the REAL classification and it again confirms the different geographic distribution of the various subtypes of malignant lymphoma. The frequency of T-/natural killer cell lineage NHL in Taiwan is higher than that in Western countries but not as high as reported previously.
本研究的目的是根据修订后的欧美淋巴系统肿瘤分类（REAL）确定台湾南部恶性淋巴瘤各亚型的分布及相对频率。
检索台湾南部一家地区医院1989 - 1998年的病理档案，查找恶性淋巴瘤、淋巴增殖性疾病及霍奇金病（HD）。将光镜、免疫组化及爱泼斯坦 - 巴尔病毒编码RNA（EBER）原位杂交结果与临床发现相关联，并根据REAL对所有病例进行分类。
共对205例病例进行回顾性分析。其中非霍奇金淋巴瘤（NHL）197例（96.1%），HD 8例（3.9%）。在197例NHL病例中，161例（81.7%）为B细胞系，36例（18.3%）为T/自然杀伤细胞系。弥漫性大B细胞淋巴瘤、结外边缘区淋巴瘤和滤泡性淋巴瘤是最常见的B细胞亚型，分别占所有NHL病例的47.2%、19.3%和6.1%。在36例T/自然杀伤细胞系病例中，未特指的外周T细胞淋巴瘤（8.6%）、T/自然杀伤细胞淋巴瘤（血管中心性淋巴瘤）（4.1%）和间变性大细胞淋巴瘤（3.6%）是最常见的亚型。8例T/自然杀伤细胞淋巴瘤病例中有7例EBER阳性。8例HD病例分为富于淋巴细胞经典型（2例）、结节硬化型（2例）和混合细胞型（4例）亚型。这8例中有3例EBER阳性。
据作者所知，本研究是台湾首次采用REAL分类，再次证实了恶性淋巴瘤各亚型的不同地理分布。台湾T/自然杀伤细胞系NHL的频率高于西方国家，但低于先前报道。
