Pileri S, Sabattini E, Tazzari P L, Gherlinzoni F, Zucchini L, Bigerna B, Leoncini L, Rosso R, Stein H, Falini B
Haematologica. 1991 May-Jun;76(3):175-82.
The authors critically review the problem of Hodgkin's disease (HD) in the light of new morphological, immunohistochemical, kinetic, genotypic, and virological findings. These support the lymphoid origin of neoplastic Hodgkin's and Reed-Sternberg cells, because of regular expression of the CD30 lymphoid activation antigen and frequent detection of B- or T-cell phenotypic and/or genotypic markers. It is possible to hypothesize the release of cytokines by tumoral elements as well as the presence of specific cytokine receptors on their surface. This might explain some clinical and pathological features, such as fever, loss of weight, eosinophilia and attraction of reactive elements that make up the composite cellular milieu of typical HD. Integration of monoclonal EBV in the genoma of neoplastic elements has repeatedly been shown, and this might play an essential role in the pathogenesis of the disease. On the basis of present concepts, the borderlines between HD and some categories of non-Hodgkin's lymphomas--especially the anaplastic large cell forms--have become somewhat blurred. Additional research work in the field of HD is desirable and might pave the way for new and more effective therapeutic approaches, designed on the basis of the natural history of the neoplasm.
作者根据新的形态学、免疫组织化学、动力学、基因分型和病毒学研究结果，对霍奇金淋巴瘤（HD）问题进行了批判性回顾。这些研究结果支持肿瘤性霍奇金细胞和里德 - 斯腾伯格细胞起源于淋巴细胞，这是因为CD30淋巴激活抗原的规律性表达以及B细胞或T细胞表型和/或基因标记物的频繁检测。可以推测肿瘤成分会释放细胞因子，并且其表面存在特定的细胞因子受体。这可能解释了一些临床和病理特征，如发热、体重减轻、嗜酸性粒细胞增多以及构成典型HD复合细胞环境的反应性成分的聚集。肿瘤成分基因组中反复出现单克隆EBV整合，这可能在疾病发病机制中起重要作用。基于目前的概念，HD与某些类型的非霍奇金淋巴瘤——尤其是间变性大细胞型——之间的界限已变得有些模糊。HD领域需要更多的研究工作，这可能为基于肿瘤自然史设计的新的、更有效的治疗方法铺平道路。
