Mathé G, Belpomme D, Dantchev D, Khalil A, Afifi A M, Taleb N, Pouillart P, Schwarzenberg L, Hayat M, De Vassal F, Jasmin C, Misset J L, Musset M
Biomedicine. 1975 Nov;22(6):473-88.
We have studied 20 cases of haematosarcomas belonging to lymphosarcomas (T or B-cell markers, absence of the reticulosarcoma characters in sections, on smears, with conventional and scanning electron microscopy). Their cells which appear as large pyroninophilic cells on sections, as large very basophilic cells with blastic nuclei and often cytoplasmic vacuoles on smears, as having many polyribosomes and usually no ergastoplasm with conventional electron microscopy, and as large cells of the lymphocytic series with scanning electron microscopy resemble the cells which we described in adenitis in 1955 (9) and in the graft-versus-host-reaction in 1961 (6), which Gowans (15) showed resulted from lymphocyte transformation, and which Dameshek (10) called immunoblasts. Many of these cases of immunoblastic lymphosarcoma (ILS) identified on their cytohistological characteristics [also recognized by Lukes et al. (24, 25) and Lennert et al. (21, 22)], present aetiological, clinical and pronostic characters which let us suppose that it may be not only a cytological entity but also a cytoclinical entity : a) it affects males in 85% or the subjects; eight patients came from mediterranean countries outside France; two patients had a history of chronic rheumatoid manifestations; b) the disease was at stage IV at the first presentation in 10 patients out of 20; it was revealed by profound (mediastinal or abdominal) localizations in 60% of cases (12 out of 20); it presented a hypoglobulinaemia in eight out of 13 patients; in six out of the 15 patients treated before leukaemic conversion, the chemotherapy usually efficient in lymphosarcoma (LS) failed to induce remission. This type of LS has a poorer prognosis than other types of LS (median for all stages : eight months). It led to the death either after its conversion to leukaemia (nine out of 20 cases), or by vital organ (as brain or kidney) infiltrations.
我们研究了20例属于淋巴肉瘤的血细胞肉瘤（通过T或B细胞标志物、切片及涂片上无网状肉瘤特征，采用传统及扫描电子显微镜观察）。其细胞在切片上表现为大的嗜派洛宁细胞，在涂片上表现为具有母细胞样核且常有胞质空泡的大嗜碱性细胞，传统电子显微镜观察显示有许多多核糖体且通常无内质网，扫描电子显微镜观察显示为淋巴细胞系列的大细胞，类似于我们在1955年（9）的腺炎及1961年（6）的移植物抗宿主反应中所描述的细胞，戈万斯（15）表明这些细胞是淋巴细胞转化产生的，达梅谢克（10）称其为免疫母细胞。许多根据细胞组织学特征鉴定的免疫母细胞性淋巴肉瘤（ILS）病例[卢克斯等人（24,25）及伦纳特等人（21,22）也认可]，具有病因、临床及预后特征，这使我们推测它可能不仅是一种细胞学实体，也是一种细胞临床实体：a）85%的患者为男性；8名患者来自法国以外的地中海国家；2名患者有慢性类风湿表现病史；b）20例患者中10例初诊时疾病处于IV期；60%的病例（20例中的12例）表现为深部（纵隔或腹部）定位；13例患者中有8例出现低球蛋白血症；15例在白血病转化前接受治疗的患者中，6例对通常对淋巴肉瘤（LS）有效的化疗未能诱导缓解。这种类型的LS比其他类型的LS预后更差（所有阶段的中位数：8个月）。它要么在转化为白血病后导致死亡（20例中的9例），要么因重要器官（如脑或肾）浸润而死亡。
