Budde R, Schaefer H E
Pathologisches Institut, Universität Freiburg.
Verh Dtsch Ges Pathol. 1992;76:136-9.
We studied iliac crest biopsies of 120 patients with extramedullary high-grade Non-Hodgkin's lymphomas (NHL). The bone marrow of 69 patients contained foci of small lymphoid cells, which cytologically differed significantly from the extramedullary NHL and which we termed abnormal lymphoid infiltrates (ALI). The ALIs in 14 out of 25 cases immunohistochemically investigated in more detail were made up of small CD3+ cells optionally intermingled with a minority of CD20+ cells of small to intermediate size. In 10 patients, however, the ALIs satisfied the criteria of a low-grade NHL. In the vicinity of the extramedullary high-grade lymphoma, residues of the corresponding low-grade NHL were identified in up to 7 of 10 cases. We conclude that bone marrow ALIs associated with extramedullary high-grade NHL exhibit at least in part the criteria of a systemic clonal expansion of premalignant lymphoid cells or low-grade NHLs respectively, which gives rise to the final evolution of the extramedullary high-grade NHL.
我们研究了120例髓外高级别非霍奇金淋巴瘤(NHL)患者的髂嵴活检标本。69例患者的骨髓中存在小淋巴细胞灶,其细胞学特征与髓外NHL有显著差异,我们将其称为异常淋巴细胞浸润(ALI)。在25例经更详细免疫组织化学研究的病例中,14例的ALI由小CD3 +细胞组成,这些细胞可与少数小至中等大小的CD20 +细胞混合存在。然而,在10例患者中,ALI符合低级别NHL的标准。在10例病例中,多达7例在髓外高级别淋巴瘤附近发现了相应低级别NHL的残留。我们得出结论,与髓外高级别NHL相关的骨髓ALI至少部分分别表现出癌前淋巴细胞或低级别NHL系统性克隆性扩增的标准,这导致了髓外高级别NHL的最终演变。