Kojima M, Hosomura Y, Itoh H, Johshita T, Yoshida K, Nakamura S, Suchi T
Department of Pathology, Tochigi National Hospital, Utsunomiya, Japan.
Acta Pathol Jpn. 1990 Apr;40(4):249-54. doi: 10.1111/j.1440-1827.1990.tb01558.x.
In 22 cases of rheumatoid arthritis (RA), including 4 cases of malignant RA (MRA), reactive proliferative lymph node lesions were studied clinicopathologically and immunohistochemically. This series included 5 males and 17 females. The period between disease onset and lymph node biopsy ranged from 3 months to 41 years. Generalized lymphadenopathy was noted in 13 cases and constitutional symptoms in 8. The histological findings characteristic of RA were 1) follicular hyperplasia with active germinal centers and 2) polyclonal plasma cell infiltration in the interfollicular area. Studies of intracytoplasmic immunoglobulin showed that gamma-heavy chain-expressing plasma cells were a major component in the interfollicular area in 17 RA cases. However, in 4 MRA cases, a prominent increase of mu chain-expressing plasma cells was recognized in the same area. In the 3 cases for which fresh tissue sections were stained with monoclonal antibodies against lymphocytes, we found that the majority of T cells in the interfollicular area had helper/inducer markers. The identical locations of the T cell population and plasma cells indicated that both played a role in the proliferation and/or differentiation of B cells in lymph nodes in RA.
对22例类风湿关节炎（RA）患者，包括4例恶性类风湿关节炎（MRA）患者的反应性增生性淋巴结病变进行了临床病理和免疫组化研究。该系列包括5名男性和17名女性。疾病发作至淋巴结活检的时间间隔为3个月至41年。13例出现全身淋巴结肿大，8例出现全身症状。RA的组织学特征为：1）生发中心活跃的滤泡增生；2）滤泡间区多克隆浆细胞浸润。胞质内免疫球蛋白研究显示，17例RA患者的滤泡间区以表达γ重链的浆细胞为主。然而，在4例MRA患者中，同一区域可见表达μ链的浆细胞显著增多。在3例新鲜组织切片用抗淋巴细胞单克隆抗体染色的病例中，我们发现滤泡间区的大多数T细胞具有辅助/诱导标志物。T细胞群体和浆细胞的位置相同，表明两者在RA患者淋巴结中B细胞的增殖和/或分化中均起作用。
