Meister H P
Institut für Pathologie, Städt, Krankenhaus München-Harlaching.
Verh Dtsch Ges Pathol. 1992;76:140-5.
Among annually 1000 consultation cases of soft tissue tumors, minimally 1.2% to maximally 2% malignant lymphomas could be identified, which presented as (primary) soft tissues tumor. Thus malignant lymphoma as soft tissue tumor is rare, however, it has to be considered in differential diagnosis not only of cellular round cell sarcoma, but also with undifferentiated carcinomas (large cell Ki-1 lymphomas) and various myxoid spindle cell sarcomas (sarcomatoid lymphoma). Decisive in differential diagnosis were decorations with pan-leucocyte antibody, as well as, B- and T-cell markers. All cases turned out to be non-Hodgkin lymphomas, the majority of B-cell type, with large cells which qualified as centroblasts (according to Kiel classification). Similar findings, predominance of B-cell non-Hodgkin lymphomas with large cells, were reported in the few series published of malignant lymphomas as soft tissue tumors. Remarkable were relatively good prognosis with "highly malignant" morphology and preference for involvement of soft tissue even after dissemination. Future studies are requested to shed light on possible specific cellular findings as to phenotype and genotype in malignant lymphoma presenting as soft tissue tumors, as already had been done with subcutaneous T-cell lymphoma and primary lymphoma of the bone.
在每年1000例软组织肿瘤的会诊病例中，可识别出最低1.2%至最高2%的恶性淋巴瘤，其表现为（原发性）软组织肿瘤。因此，作为软组织肿瘤的恶性淋巴瘤很罕见，然而，在鉴别诊断中不仅要考虑细胞性圆形细胞肉瘤，还要考虑未分化癌（大细胞Ki-1淋巴瘤）和各种黏液样梭形细胞肉瘤（肉瘤样淋巴瘤）。鉴别诊断的决定性因素是全白细胞抗体以及B细胞和T细胞标志物的标记。所有病例均为非霍奇金淋巴瘤，大多数为B细胞型，具有符合中心母细胞（根据基尔分类）的大细胞。在已发表的少数关于作为软组织肿瘤的恶性淋巴瘤的系列研究中，也报告了类似的发现，即具有大细胞的B细胞非霍奇金淋巴瘤占优势。值得注意的是，具有“高度恶性”形态的病例预后相对较好，并且即使在扩散后也倾向于累及软组织。需要进一步的研究来阐明作为软组织肿瘤的恶性淋巴瘤在表型和基因型方面可能的特定细胞发现，就像对皮下T细胞淋巴瘤和原发性骨淋巴瘤所做的那样。
