Carbone A, Pinto A, Gloghini A, Volpe R, Zagonel V
Division of Pathology, Centro Regionale di Riferimento Oncologico, Istituto Nazionale di Ricovero, Aviano, Italy.
Hum Pathol. 1992 Apr;23(4):438-48. doi: 10.1016/0046-8177(92)90092-h.
The pathologic, immunologic, and clinical features of five cases of B-zone small lymphocytic lymphoma (BZSLL), characterized by a nondestructive growth pattern with a selective and complete replacement of the B-zone areas of lymph nodes, were examined. These findings were compared with those of 13 cases of intermediate differentiated lymphoma/mantle zone lymphoma (ILL/MZL) and 20 cases of typical small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). B-zone SLL was characterized histologically by a deceptively benign pattern at a low magnification, the lymph node architecture being substantially preserved, in contrast to the ILL/MZL and SLL/CLL cases, in which complete effacement of the normal architecture usually could be observed. Moreover, in BZSLL the cellular population was rather uniform and lacked either a prolymphocytic component or the small-cleaved lymphoid cells often seen in SLL/CLL and ILL/MZL cases, respectively. The phenotypic profile of the BZSLL clonal cell population studied by the immunoperoxidase method and by single- and double-labeling flow cytometric analyses (SIg+, CD19+, CD20+, CD21+, CD22+, CD24+, CD35+, CD37+, CD74+, CD45+, CD45R+, MB2+, HLA-DR+, Leu-8+, CD9+/-, CDw75+/-, CD5-/+, CD23-/+, CD10-, FMC7-, PCA-1-, CD25-, CD38-, CD43-, CD3-) appeared to be fairly homogeneous and sufficiently distinct from that of ILL/MZL, based on the absence of FMC7 and CD38 molecules, and from that of SLL/CLL due to significantly stronger expression of SIgs (P less than .05), the higher reactivity with anti-CD9 and -CD22 antibodies (P less than .05), the lower reactivity with anti-CD5 and -CD23 antibodies (P less than .05), and the absence of CD25 determinants. Several clinical features of patients with BZSLL, including age group, advanced stage disease, and high frequency of bone marrow and peripheral blood involvement, were similar to those found in the other patients with ILL/MZL and SLL/CLL, but none of the BZSLL patients had an absolute lymphocyte count higher than 15.0 x 10(9)/L at presentation. Based on the architectural pattern, cytologic features, immunophenotypes, and hematologic findings, we conclude that BZSLL is an unusual variant of SLL that is primary in the lymph nodes and should be distinguished from ILL/MZL and CLL.
对5例B区小淋巴细胞淋巴瘤（BZSLL）的病理、免疫和临床特征进行了研究，其特征为非破坏性生长模式，选择性并完全取代淋巴结的B区。将这些发现与13例中分化淋巴瘤/套细胞淋巴瘤（ILL/MZL）和20例典型小淋巴细胞淋巴瘤/慢性淋巴细胞白血病（SLL/CLL）的发现进行了比较。B区SLL在组织学上的特征是低倍镜下看似良性的模式，淋巴结结构基本保留，这与ILL/MZL和SLL/CLL病例不同，在ILL/MZL和SLL/CLL病例中通常可观察到正常结构完全消失。此外，在BZSLL中，细胞群体相当均匀，既没有幼淋巴细胞成分，也没有分别在SLL/CLL和ILL/MZL病例中常见的小核裂淋巴细胞。通过免疫过氧化物酶法以及单标和双标流式细胞术分析研究的BZSLL克隆细胞群体的表型谱（SIg+、CD19+、CD20+、CD21+、CD22+、CD24+、CD35+、CD37+、CD74+、CD45+、CD45R+、MB2+、HLA-DR+、Leu-8+、CD9+/-、CDw75+/-、CD5-/+、CD23-/+、CD10-、FMC7-、PCA-1-、CD25-、CD38-、CD43-、CD3-）似乎相当均一，并且基于FMC7和CD38分子的缺失，与ILL/MZL的表型谱有足够差异；由于SIgs表达明显更强（P小于0.05）、与抗CD9和抗CD22抗体的反应性更高（P小于0.05）、与抗CD5和抗CD23抗体的反应性更低（P小于0.05）以及不存在CD25决定簇，与SLL/CLL的表型谱也有足够差异。BZSLL患者的一些临床特征，包括年龄组、晚期疾病以及骨髓和外周血受累频率高，与其他ILL/MZL和SLL/CLL患者相似，但没有BZSLL患者在就诊时绝对淋巴细胞计数高于15.0×10⁹/L。基于结构模式、细胞学特征、免疫表型和血液学发现，我们得出结论，BZSLL是SLL的一种不寻常变异型，原发于淋巴结，应与ILL/MZL和CLL相鉴别。
