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肿瘤性淋巴细胞围绕脂肪细胞:一种并非皮下T细胞淋巴瘤所特有的组织病理学特征。

Rimming of adipocytes by neoplastic lymphocytes: a histopathologic feature not restricted to subcutaneous T-cell lymphoma.

作者信息

Lozzi Gian Piero, Massone Cesare, Citarella Luigi, Kerl Helmut, Cerroni Lorenzo

机构信息

Department of Dermatology, Medical University of Graz, Austria.

出版信息

Am J Dermatopathol. 2006 Feb;28(1):9-12. doi: 10.1097/01.dad.0000187933.87103.03.

Abstract

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare cytotoxic T-cell lymphoma of the skin presenting with histopathologic features simulating those of a lobular panniculitis. The presence of neoplastic T-lymphocytes forming a rim around the individual fat cells in the subcutaneous lobules, so-called "rimming" of adipocytes, is considered a characteristic morphologic feature of this type of cutaneous lymphoma. In this study we reviewed a series of 45 biopsy specimens of primary and secondary cutaneous B- and T-cell lymphomas and one of myeloid leukemia involving the subcutaneous tissues and showing rimming of adipocytes (subcutaneous panniculitis-like T-cell lymphoma: n = 16; mycosis fungoides, tumor stage: n = 3; aggressive epidermotropic CD8(+) T-cell lymphoma: n = 2; cutaneous gamma/delta T-cell lymphoma: n = 4; extranodal NK/T-cell lymphoma, nasal type: n = 4; cutaneous medium-large pleomorphic T-cell lymphoma, NOS: n = 5; CD4(+)/CD56(+) hematodermic neoplasm (blastic NK-cell lymphoma): n = 7; secondary cutaneous large B-cell lymphoma: n = 3; secondary cutaneous lymphoplasmacytic lymphoma: n = 1; specific cutaneous manifestations of acute myelogenous leukemia: n = 1). We could demonstrate that rimming of adipocytes by neoplastic cells can be recognized not only in subcutaneous panniculitis-like T-cell lymphoma, but also in several different entities of malignant lymphoma with skin involvement. Precise classification of cases with prominent involvement of the subcutaneous tissues can only be achieved upon precise correlation of clinicopathologic and phenotypic features. Rimming of adipocytes should not be considered specific of subcutaneous panniculitis-like T-cell lymphoma.

摘要

皮下脂膜炎样T细胞淋巴瘤(SPTCL)是一种罕见的皮肤细胞毒性T细胞淋巴瘤,其组织病理学特征类似于小叶性脂膜炎。肿瘤性T淋巴细胞在皮下小叶的单个脂肪细胞周围形成一圈,即所谓的脂肪细胞“镶边”,被认为是这种皮肤淋巴瘤的特征性形态学特征。在本研究中,我们回顾了一系列45例原发性和继发性皮肤B细胞和T细胞淋巴瘤以及1例累及皮下组织并显示脂肪细胞镶边的髓系白血病的活检标本(皮下脂膜炎样T细胞淋巴瘤:n = 16;蕈样肉芽肿,肿瘤期:n = 3;侵袭性亲表皮性CD8(+) T细胞淋巴瘤:n = 2;皮肤γ/δ T细胞淋巴瘤:n = 4;鼻型结外NK/T细胞淋巴瘤:n = 4;皮肤中-大细胞多形性T细胞淋巴瘤,NOS:n = 5;CD4(+)/CD56(+)血液皮肤肿瘤(母细胞性NK细胞淋巴瘤):n = 7;继发性皮肤大B细胞淋巴瘤:n = 3;继发性皮肤淋巴浆细胞淋巴瘤:n = 1;急性髓系白血病的特异性皮肤表现:n = 1)。我们可以证明,肿瘤细胞对脂肪细胞的镶边不仅可以在皮下脂膜炎样T细胞淋巴瘤中识别,而且在几种不同的累及皮肤的恶性淋巴瘤实体中也可以识别。只有在临床病理和表型特征精确相关的情况下,才能对皮下组织明显受累的病例进行精确分类。脂肪细胞镶边不应被视为皮下脂膜炎样T细胞淋巴瘤所特有的表现。

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