Hansmann M L
Institut für Pathologie, Universität zu Köln.
Verh Dtsch Ges Pathol. 1992;76:24-36.
Since 26 years Hodgkins disease is classified according to the Rye classification into 4 types. This classification is based on morphology and has turned out to be clinically relevant. However, sometimes the classification on morphological and immunohistochemical ground can be difficult to put a special case in a defined category of the 4 types. In addition, there seems to be no sharp, or well defined borders between Hodgkin's disease and Non-Hodgkin's lymphomas, especially T-cell lymphomas. Immunophenotyping of small lymphocytes and detection of follicular dendritic cells can demonstrate typical patterns in different types of Hodgkin's disease. In all types of Hodgkin's disease there is the same amount of proliferating small T-cells present. Hodgkin cells are lymphoid cells with B- or T-cell markers. Hodgkin cells of nodular para-granuloma (lymphocyte predominant type of Hodgkin's disease) show m-RNA for one light chain in the cytoplasm which can be visualized by in situ-hybridization. A new technique called "molecular histology" is applied to Hodgkin's disease. This is a single cell PCR of immunostained cells extracted from tissue sections by a micromanipulator. This technique enables us for the first time to demonstrate light chain and heavy chain gene rearrangements in Hodgkin cells of nodular sclerosis and mixed cellularity type. Hodgkin's disease seems to be no single entity but a heterogenous group of B- and possibly T-cell lymphomas. In the B-cell types Hodgkin cells are probably pre-B and B-cells.
26年来,霍奇金病一直根据赖氏分类法分为4种类型。这种分类基于形态学,且已证明具有临床相关性。然而,有时基于形态学和免疫组织化学的分类可能难以将特殊病例归入这4种类型中的某一特定类别。此外,霍奇金病与非霍奇金淋巴瘤,尤其是T细胞淋巴瘤之间似乎没有清晰或明确的界限。小淋巴细胞的免疫表型分析和滤泡树突状细胞的检测可以显示不同类型霍奇金病的典型模式。在所有类型的霍奇金病中,增殖的小T细胞数量相同。霍奇金细胞是具有B或T细胞标志物的淋巴细胞。结节性副肉芽肿(淋巴细胞为主型霍奇金病)的霍奇金细胞在细胞质中显示一条轻链的mRNA,可通过原位杂交可视化。一种名为“分子组织学”的新技术被应用于霍奇金病。这是一种对通过显微操作器从组织切片中提取的免疫染色细胞进行单细胞PCR。这项技术首次使我们能够在结节硬化型和混合细胞型霍奇金细胞中证明轻链和重链基因重排。霍奇金病似乎不是单一实体,而是B细胞和可能的T细胞淋巴瘤的异质性群体。在B细胞类型中,霍奇金细胞可能是前B细胞和B细胞。