Liu Yanhui, Zhu Xiongzeng, Zhuang Hengguo, Lin Hanliang, Wu Qiuliang, Jiang Guangyu, Gu Yingying, Luo Donglan, Luo Xinlan
Department of Pathology, Guangdong Provincial People's Hospital, Guangzhou 510080, China.
Zhonghua Bing Li Xue Za Zhi. 2002 Jun;31(3):227-30.
To study the diagnosis and the differential diagnosis of nodular lymphocyte-predominant Hodgkin's lymphoma (NLPHL).
245 cases of Hodgkin's lymphoma (HL) diagnosed between 1980 and 2000 from 3 hospitals in Guangzhou were reviewed. Four cases of NLPHL were confirmed according to the WHO classification of lymphoid neoplasms. Among the other 3 cases of NLPHL, 2 collected from other clinical centers and 1 from Fudan University Cancer Hospital. Immunohistochemistry (IHC) were performed on paraffin sections through SP technique using a panel of markers to define the large neoplastic cells (CD45, CD20, CD15, CD30 and vimentin) as well as the non-neoplastic background cells (CD3, CD20, CD45RO, CD57, CD68 and TIA-1).
Seven patients with NLPHL were 4 males and 3 females, age 29 to 70 years, average 43.8 years. All patients had lymphadenopathy. Histologically, in NLPHL, instead of the structure of normal lymph nodes, the tumor tissue became nodular in architecture. Characteristic lymphocytic and histiocytic (L&H) cells with scant cytoplasm and large multilobulated nuclei distributed among a predominant population of small lymphoid cells. The large cells exhibited a CD45+, CD20+, but CD15-, CD30- and vimentin-phenotype. The background cellularity was relatively rich in B cells and the majority of T-cells infiltrated were CD57(+) cells. TIA-1+ cells were few.
NLPHL can be diagnosed according to the morphologic and immunophenotypic features rather than by morphology alone. It is important to distinguish this tumor from its morphologic mimics, such as lymphocyte-rich classical Hodgkin's lymphoma (LRCHL) and T-cell rich B-cell lymphoma (TCRBCL). The immunophenotype of neoplastic cells and background cells are the helpful criteria for the differential diagnosis.
研究结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）的诊断及鉴别诊断。
回顾性分析1980年至2000年间广州3家医院诊断的245例霍奇金淋巴瘤（HL）。根据世界卫生组织淋巴造血系统肿瘤分类标准确诊4例NLPHL。另外3例NLPHL中，2例来自其他临床中心，1例来自复旦大学附属肿瘤医院。采用免疫组织化学（IHC）SP法检测石蜡切片，用一组标记物来确定肿瘤大细胞（CD45、CD20、CD15、CD30和波形蛋白）以及非肿瘤背景细胞（CD3、CD20、CD45RO、CD57、CD68和TIA-1）。
7例NLPHL患者中，男性4例，女性3例，年龄29至70岁，平均43.8岁。所有患者均有淋巴结肿大。组织学上，NLPHL的肿瘤组织呈结节状结构，而非正常淋巴结结构。特征性的淋巴细胞和组织细胞（L&H）细胞，胞质稀少，核呈多叶状，分布于以小淋巴细胞为主的细胞群中。大细胞表现为CD45+、CD20+，但CD15-、CD30-及波形蛋白阴性表型。背景细胞中B细胞相对丰富，浸润的T细胞多数为CD57(+)细胞。TIA-1+细胞少见。
NLPHL可根据形态学和免疫表型特征诊断，而非仅依靠形态学。将该肿瘤与其形态学相似的疾病，如富于淋巴细胞的经典型霍奇金淋巴瘤（LRCHL）和富于T细胞的B细胞淋巴瘤（TCRBCL）相鉴别很重要。肿瘤细胞和背景细胞的免疫表型是鉴别诊断的有用标准。
