Kojima M, Tanaka H, Matsuda H, Iijima M, Motoori T, Masawa N
Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
APMIS. 2005 Sep;113(9):638-42. doi: 10.1111/j.1600-0463.2005.apm_274.x.
We here report two unusual cases of floral variant of follicular lymphoma containing marginal zone B-cells. Histologically, the neoplastic follicles consisted of three distinct layers. The inner layer was composed of neoplastic germinal centers exhibiting a floral design and the middle layer had unusually prominent mantle zones. The outer zone of neoplastic follicles was surrounded by a pale cuff of marginal zone B-cells. Immunohistological study demonstrated that both the germinal center and marginal zone component lay within the follicular dendritic cell network. The germinal center component was CD10+ and bcl-2+. However, a portion of the marginal zone component weakly expressed bcl-2 but not CD10. Nodal marginal zone B-cell lymphoma (NMZBL) occasionally possesses "floral" lymphoid follicles. Follicular lymphoma with marginal zone differentiation is a high-risk variant of follicular lymphoma. In diagnostic practice, the differential diagnosis between the floral variant of follicular lymphoma containing marginal zone B-cells and the "floral variant" of NMZBL is important.
我们在此报告两例含有边缘区B细胞的滤泡性淋巴瘤花型变异的不寻常病例。组织学上，肿瘤性滤泡由三个不同层次组成。内层由呈现花型结构的肿瘤性生发中心构成，中间层有异常突出的套区。肿瘤性滤泡的外层被边缘区B细胞形成的淡染套袖样结构所环绕。免疫组织学研究表明，生发中心和边缘区成分均位于滤泡树突状细胞网络内。生发中心成分CD10阳性且bcl-2阳性。然而，部分边缘区成分bcl-2弱表达但CD10阴性。结内边缘区B细胞淋巴瘤（NMZBL）偶尔会出现“花型”淋巴滤泡。伴有边缘区分化的滤泡性淋巴瘤是滤泡性淋巴瘤的高危变异型。在诊断实践中，鉴别含有边缘区B细胞的滤泡性淋巴瘤花型变异与NMZBL的“花型变异”很重要。
