Sukpanichnant Sanya
Department of Pathology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Hum Pathol. 2004 Feb;35(2):224-30. doi: 10.1016/j.humpath.2003.10.007.
Studying a large series of malignant lymphoma is important to increasing our understanding of this disease. Based on the World Health Organization classification system, 1983 cases of lymphoma at Siriraj Hospital were classified as either non-Hodgkin lymphoma (NHL) (92.1%) or Hodgkin lymphoma (HL) (7.9%). The NHL cases were 75% B cell type and 25% T cell type. Diffuse large B-cell lymphoma, unspecified peripheral T-cell lymphoma, follicular lymphoma, extranodal marginal zone B-cell lymphoma, precursor T lymphoblastic lymphoma, and Burkitt lymphoma accounted for 84.3% of all NHL cases found. Mixed cellularity and nodular sclerosis types constituted 77.7% of the HL cases found. An overall male preponderance was observed, but sex distribution differed among various types of lymphoma, and a female preponderance was observed in the elderly subjects. Changes in the frequency of B-cell NHL by age were characteristic: <50% in the first decade of life, a further decrease in the second decade, >60% in the third decade, and increases thereafter, reaching 90% after the seventh decade. High frequency of follicular lymphoma in Bangkok but low frequency in the Northeastern region and high frequency of HL in the Southern region were significant (P <0.05). Extranodal involvement was observed in 58.7% of NHLs, commonly affecting the upper aerodigestive tract and gastrointestinal tract, with some differences in geographical distribution. Higher frequencies of T-cell NHLs involving extranodal sites and of B-cell NHLs involving lymph nodes were significant (P <0.05). The distribution of various types of lymphoma and comparison with other large series of lymphoma further demonstrates the heterogeneity of this disease.
研究大量恶性淋巴瘤病例对于增进我们对这种疾病的了解非常重要。根据世界卫生组织分类系统,诗里拉吉医院的1983例淋巴瘤病例被分类为非霍奇金淋巴瘤(NHL)(92.1%)或霍奇金淋巴瘤(HL)(7.9%)。NHL病例中75%为B细胞型,25%为T细胞型。弥漫性大B细胞淋巴瘤、未特定的外周T细胞淋巴瘤、滤泡性淋巴瘤、结外边缘区B细胞淋巴瘤、前体T淋巴母细胞淋巴瘤和伯基特淋巴瘤占所有发现的NHL病例的84.3%。混合细胞型和结节硬化型占所发现的HL病例的77.7%。总体上观察到男性占优势,但不同类型淋巴瘤的性别分布有所不同,老年受试者中观察到女性占优势。B细胞NHL的频率随年龄变化具有特征性:生命的第一个十年中<50%,第二个十年中进一步下降,第三个十年中>60%,此后上升,第七个十年后达到90%。曼谷滤泡性淋巴瘤的高频率但东北部地区的低频率以及南部地区HL的高频率具有显著性(P<0.05)。58.7%的NHL观察到结外受累,通常影响上呼吸道消化道和胃肠道,地理分布存在一些差异。累及结外部位的T细胞NHL和累及淋巴结的B细胞NHL的较高频率具有显著性(P<0.05)。各种类型淋巴瘤的分布以及与其他大量淋巴瘤系列的比较进一步证明了这种疾病的异质性。