Carbone A, Gloghini A, Volpe R, Attadia V, Gattei V, Zagonel V, Pinto A
Division of Pathology, Centro Regionale di Riferimento Oncologico, Aviano, Italy.
Am J Clin Pathol. 1992 Oct;98(4):437-48. doi: 10.1093/ajcp/98.4.437.
The authors have observed a unique case of follicular lymphoma in which the central zones of neoplastic nodules were composed predominantly of small cleaved cells (SCC) that were surrounded by small lymphoid cells proliferating in wide mantles as in mantle zone (MZ) lymphoma. The central SCC component displayed a follicular SCC lymphoma-like phenotype (IgD-, CD10+, CD5-, CD68-), whereas the neoplastic cells of the peripheral zones had an MZ lymphoma-like phenotypic profile (IgD+, CD10-, CD5+, CD68+). In extranodal involved tissues, either follicular or diffuse (leukemic-like) patterns of lymphoma infiltration were noted. Flow cytometric analyses showed in the bone marrow or the peripheral blood two leukemic B cell populations, one mimicking the phenotypic profile (IgM+, IgD+, CD5+, CD10-, Leu8-) of small lymphoid cells with MZ-like features, and the other with phenotypic features (IgM+, IgD-, CD5+, CD10+, Leu8+) intermediate between those of MZ-like cells and those of the SCC component (follicular center-like) detected in the lymph node. Immunomagnetic sorting and gene rearrangement studies indicated that both CD10+ and CD10- B lymphocytes and lymph node neoplastic B cells shared the same clonal origin. This unusual follicular lymphoma can be viewed as the result of the proliferation of a single follicular progenitor capable of differentiating toward both a germinal center and an MZ phenotype. The simultaneous presence in the same patient of at least three neoplastic B-cell populations at different maturation stages, encompassing follicular center and MZ phenotypes, and showing the same clonal derivation, indicates a close lineage relationship between follicular SCC and MZ lymphomas.
作者观察到一例独特的滤泡性淋巴瘤，其中肿瘤结节的中心区域主要由小裂细胞（SCC）组成，这些小裂细胞被小淋巴细胞围绕，小淋巴细胞在宽的边缘带增殖，如同边缘区（MZ）淋巴瘤。中心SCC成分表现出滤泡性SCC淋巴瘤样表型（IgD阴性、CD10阳性、CD5阴性、CD68阴性），而周边区域的肿瘤细胞具有MZ淋巴瘤样表型特征（IgD阳性、CD10阴性、CD5阳性、CD68阳性）。在结外受累组织中，观察到淋巴瘤浸润的滤泡性或弥漫性（白血病样）模式。流式细胞术分析显示，在骨髓或外周血中有两个白血病性B细胞群体，一个模仿具有MZ样特征小淋巴细胞的表型特征（IgM阳性、IgD阳性、CD5阳性、CD10阴性、Leu8阴性），另一个具有介于MZ样细胞和在淋巴结中检测到的SCC成分（滤泡中心样）之间的表型特征（IgM阳性、IgD阴性、CD5阳性、CD10阳性、Leu8阳性）。免疫磁珠分选和基因重排研究表明，CD10阳性和CD10阴性B淋巴细胞以及淋巴结肿瘤性B细胞具有相同的克隆起源。这种不寻常的滤泡性淋巴瘤可被视为单个滤泡祖细胞增殖的结果，该祖细胞能够向生发中心和MZ表型分化。同一患者同时存在至少三个处于不同成熟阶段的肿瘤性B细胞群体，包括滤泡中心和MZ表型，并显示相同的克隆来源，这表明滤泡性SCC和MZ淋巴瘤之间存在密切的谱系关系。
