Bayerl Michael G, Bentley Gail, Bellan Cristiana, Leoncini Lorenzo, Ehmann W Christopher, Palutke Margarita
Department of Pathology, Hematology/Oncology, Penn State University School of Medicine, M.S. Hershey Medical Center, Hershey, PA 17033, USA.
Am J Clin Pathol. 2004 Dec;122(6):858-64. doi: 10.1309/PMR8-6PHK-K4J3-RUH3.
Two cases of follicular lymphoma (FL) with numerous large cells resembling the lacunar and Hodgkin and Reed-Sternberg (HRS) cells of classic Hodgkin lymphoma were studied to determine clonal relationships between the HRS-like cells and centrocytic and centroblastic (CCCB) cells. In both cases, CCCB cells were typical of FL; CD45RB, CD20, CD10 and BCL-2 positive. In case 1, the HRS-like cells were positive for CD45RB, CD20, CD10, CD30, OCT2, and BOB.1 and negative for CD15 and bcl-2. In case 2, the HRS-like cells were positive for CD30, fascin, CD20, OCT2, and BOB.1 and negative for CD45RB, CD10, CD15, and bcl-2. CCCB and single HRS-like cells were isolated by laser capture microdissection followed by polymerase chain reaction amplification and sequencing of immunoglobulin heavy chain gene rearrangements. In both cases, identical sequences were obtained from CCCB and HRS-like cells. These findings confirm that although the HRS cells and CCCB cells in these cases demonstrate morphologic and immunophenotypic divergence, they share a common cell of origin. These cases further highlight the potential diagnostic pitfall presented by FL with HRS-like cells.
对两例滤泡性淋巴瘤（FL）进行了研究，这两例中有许多大细胞，类似于经典霍奇金淋巴瘤的陷窝细胞以及霍奇金和里德-斯腾伯格（HRS）细胞，以确定HRS样细胞与中心细胞和中心母细胞（CCCB）之间的克隆关系。在这两例中，CCCB细胞均为典型的FL细胞；CD45RB、CD20、CD10和BCL-2呈阳性。在病例1中，HRS样细胞CD45RB、CD20、CD10、CD30、OCT2和BOB.1呈阳性，CD15和bcl-2呈阴性。在病例2中，HRS样细胞CD30、fascin、CD20、OCT2和BOB.1呈阳性，CD45RB、CD10、CD15和bcl-2呈阴性。通过激光捕获显微切割分离出CCCB和单个HRS样细胞，随后进行聚合酶链反应扩增和免疫球蛋白重链基因重排测序。在这两例中，CCCB和HRS样细胞获得了相同的序列。这些发现证实，尽管这些病例中的HRS细胞和CCCB细胞在形态学和免疫表型上存在差异，但它们有共同的起源细胞。这些病例进一步凸显了伴有HRS样细胞的FL可能存在的诊断陷阱。
