Chirife Ana M, Bilbao Erica Rojas, Giménez Liliana, Marino Lina
Departamento de Patología, Instituto de Oncología Angel H. Roffo, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina (B Aires). 2006;66(4):307-12.
Cutaneous lymphomas are low grade malignant neoplasms with favourable prognosis. Those related to the germinal centre with nodular pattern may be: follicular lymphomas (LFC) or extranodal marginal zone B-cell lymphomas (LMC). They are difficult to tell apart, and from reactive processes like cutaneous follicular hyperplasia and cutis immunocytomas. The objective of this study was to check the incidence and the value of both histology and immunohistochemistry in differential diagnosis. Fifty six patients with cutaneous lymphomas were selected within the period 1995-2004. The biopsies were studied with hematoxilin eosin and immunohistochemistry. Thirty two out of the fifty six cutaneous lymphoid infiltrates were of T origin (57.1%) and twenty four of B origin (42.8%), ten out of this last figure (17.7%) were lymphoid processes with nodular pattern Four LFC, three LMC and three HLC were diagnosed. Convergent follicles with scarce mantle and germinal centres with monomorph celullarity were observed in the LFC. Among the LMC, follicles with prominent mantle and nests of monocitoid cells in the mantle, interfollicular zone and in the germinal centers observed. In the HLC macrophages with detritus were found in the germinal centers. LFC showed: CD20 (+), CD 10 (+), bcl-2 (+) or (-), and bcl-6 (+) in the follicle and in the interfollicular area. LMC showed: CD 20 (+), bcl-2 (-), CD 10 (+/-), and bcl-6 (+) in the follicle, and bcl-2 (+), CD10 (-/+) and bcl-6 (-) in the interfollicular area. The HLC results were: bcl-2 (-), bcl-6 (+) and CD 10 (-) in the follicle and bcl-2 (+), bcl-6 (-) and CD 10 (-) in the interfollicular zone. We conclude that lymphoid B cell processes with nodular pattern are unusual. Histology and immunohistochemistry proved to be useful in the differential diagnosis of these lymphomas, and for differentiating these from lymphoid hyperplasias or non tumoral hyperplasias.
皮肤淋巴瘤是预后良好的低度恶性肿瘤。那些与具有结节模式的生发中心相关的可能是：滤泡性淋巴瘤（LFC）或结外边缘区B细胞淋巴瘤（LMC）。它们很难区分，也难以与诸如皮肤滤泡增生和皮肤免疫细胞瘤等反应性过程区分开来。本研究的目的是检查组织学和免疫组织化学在鉴别诊断中的发生率和价值。在1995年至2004年期间选择了56例皮肤淋巴瘤患者。对活检组织进行苏木精伊红染色和免疫组织化学研究。56例皮肤淋巴浸润中有32例起源于T细胞（57.1%），24例起源于B细胞（42.8%），后者中有10例（17.7%）是具有结节模式的淋巴过程。诊断出4例LFC、3例LMC和3例HLC。在LFC中观察到具有稀少套区的汇聚滤泡和具有单形细胞的生发中心。在LMC中，观察到具有突出套区的滤泡以及套区、滤泡间区和生发中心中的单核样细胞巢。在HLC中，在生发中心发现有碎屑的巨噬细胞。LFC显示：在滤泡和滤泡间区域CD20（+）、CD10（+）、bcl-2（+）或（-）以及bcl-6（+）。LMC显示：在滤泡中CD20（+）、bcl-2（-）、CD10（+/-）以及bcl-6（+），在滤泡间区域bcl-2（+）、CD10（-/+）以及bcl-6（-）。HLC的结果是：在滤泡中bcl-2（-）、bcl-6（+）以及CD10（-），在滤泡间区域bcl-2（+）、bcl-6（-）以及CD10（-）。我们得出结论，具有结节模式的B细胞淋巴过程并不常见。组织学和免疫组织化学被证明在这些淋巴瘤的鉴别诊断中以及将它们与淋巴增生或非肿瘤性增生区分开来方面是有用的。
