Loke S L, Ho F, Srivastava G, Fu K H, Leung B, Liang R
Department of Pathology, University of Hong Kong, Queen Mary Hospital.
Am J Pathol. 1992 Apr;140(4):981-9.
Seventeen nodal lymphomas (originally diagnosed as T-cell lymphomas based on histological features and immunohistochemical staining results) were studied for the presence of Epstein-Barr virus (EBV) genome, and the results correlated with immunoglobulin and T-cell receptor gene rearrangement analyses performed on the same tissue samples. All four EBV positive cases had clonal rearrangement of the joining region of the immunoglobulin heavy chain (IgJH) gene without clonal T-cell receptor beta-chain (TCR beta) gene rearrangement. Of these, two cases also showed clonally rearranged light chain gene, and they were reclassified as T-cell rich B-cell lymphomas (TRBL). The other two cases lacked clonal kappa or lambda light chain rearrangement and they were reclassified as T-cell rich lymphomas of probable B lineage, based on their isolated IgJH clonal rearrangement. These B-cell lymphomas may be easily misdiagnosed as T-cell lymphomas owing to the presence of an abundant reactive T-cell infiltrate masking the tumor population. The florid T-cell reaction may represent an unusual host response towards a clonal proliferation of EBV bearing B cells.
对17例淋巴结淋巴瘤（最初根据组织学特征和免疫组化染色结果诊断为T细胞淋巴瘤）进行了爱泼斯坦-巴尔病毒（EBV）基因组检测，并将结果与对同一组织样本进行的免疫球蛋白和T细胞受体基因重排分析进行关联。所有4例EBV阳性病例均有免疫球蛋白重链（IgJH）基因连接区的克隆性重排，而无克隆性T细胞受体β链（TCRβ）基因重排。其中，2例还显示有克隆性重排的轻链基因，它们被重新分类为富于T细胞的B细胞淋巴瘤（TRBL）。另外2例缺乏克隆性κ或λ轻链重排，基于其孤立的IgJH克隆性重排，它们被重新分类为可能为B细胞系的富于T细胞的淋巴瘤。由于存在丰富的反应性T细胞浸润掩盖了肿瘤细胞群，这些B细胞淋巴瘤可能很容易被误诊为T细胞淋巴瘤。活跃的T细胞反应可能代表了宿主对携带EBV的B细胞克隆性增殖的一种异常反应。
