Herling Marco, Jones Dan
Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Am J Clin Pathol. 2007 May;127(5):687-700. doi: 10.1309/FY6PK436NBK0RYD4.
Described herein is the evolution in the diagnosis and classification of tumors that are variously known as blastic or blastoid natural killer cell lymphoma, CD4+/CD56+ hematodermic neoplasm, or tumors of plasmacytoid dendritic cell lineage. As illustrated by cases submitted to the 2005 Society for Hematopathology/European Association for Haematopathology Workshop, these tumors display a range of clinical manifestations and various morphologic and immunophenotypic features. Recent evidence suggests a close histogenetic relationship for most cases to plasmacytoid dendritic cells. We outline the typical presenting features and the clinical course of CD4+/CD56+ hematodermic tumors, including leukemic relapses with shifts to myelomonocytic differentiation. The currently unresolved issues are largely related to the limits of this entity, particularly the relationship to myeloid leukemia and undifferentiated blastic neoplasms, with which there is diagnostic overlap. Although questions remain, delineation of the CD4+/CD56+ hematodermic tumor and its improved recognition has already served as a catalyst toward better understanding of the multilineage potential of hematopoietic malignancies.
本文描述了多种被称为母细胞性或母细胞样自然杀伤细胞淋巴瘤、CD4+/CD56+血液皮肤肿瘤或浆细胞样树突状细胞系肿瘤的诊断和分类的演变。正如提交给2005年血液病理学学会/欧洲血液病理学协会研讨会的病例所示，这些肿瘤表现出一系列临床表现以及各种形态学和免疫表型特征。最近的证据表明，大多数病例与浆细胞样树突状细胞存在密切的组织发生关系。我们概述了CD4+/CD56+血液皮肤肿瘤的典型表现特征和临床病程，包括白血病复发并伴有向髓单核细胞分化的转变。目前尚未解决的问题在很大程度上与该实体的局限性有关，特别是与髓系白血病和未分化母细胞性肿瘤的关系，它们在诊断上存在重叠。尽管问题依然存在，但CD4+/CD56+血液皮肤肿瘤的界定及其识别的改善已经成为更好地理解造血恶性肿瘤多系潜能的催化剂。
