Nakamura S, Suchi T
Department of Pathology, Aichi Cancer Center Hospital, Nagoya, Japan.
Cancer. 1991 May 15;67(10):2566-78. doi: 10.1002/1097-0142(19910515)67:10<2565::aid-cncr2820671029>3.0.co;2-4.
Postthymic (peripheral) T-cell malignancy shows marked diversity in histopathologic appearances as well as in clinical and prognostic aspects. Histologic findings and clinical behavior of 110 cases of the three specific types of low-grade, peripheral T-cell lymphomas, i.e., lymphoepithelioid (LeL), angioimmunoblastic (AILD), and T-zone (TzL) lymphomas, were studied. There were 74 men and 36 women (age range, 24 to 90 years; median, 58). Histologic study of LeL, AILD, and TzL showed prominent reactive features which are distinct from those of high-grade, T-cell lymphomas (pleomorphic/immunoblastic types). Corresponding to the differences in the histologic pictures of each type, there were differences in the clinical pictures and prognosis. Hypergammablobulinemia (greater than 4 g/dl) was more common in AILD than in the others. However, these three types exhibited a widely variegated, sometimes overlapping spectrum of histologic appearances, and it was extremely difficult to distinguish one from the other on several occasions. The same was true of their clinical and laboratory findings, and they had a relatively favorable prognosis as compared with pleomorphic/immunoblastic lymphomas. Although the conventional phenotypic analysis showed the prominent mixture of helper/inducer and cytotoxic/suppressor T-cells with a varying degree of B-cells and histiocytes, the double immunohistochemical study revealed that the neoplastic cells consisted predominantly of helper/inducer cells. Furthermore, five cases (5%) showed the morphologic transition among the three types or development into pleomorphic/immunoblastic lymphoma. They seemed to constitute a comprehensive and yet distinct group of T-cell lymphomas. Based on morphologic findings and clinical data, the authors demonstrated the distinct character of the node-based, low-grade, T-cell lymphomas and also the relationship among the three types in this group. The results of phenotypic and genotypic analyses also support the concept proposed here.
胸腺后（外周）T细胞恶性肿瘤在组织病理学表现以及临床和预后方面显示出明显的多样性。对110例三种特定类型的低度外周T细胞淋巴瘤，即淋巴上皮样（LeL）、血管免疫母细胞性（AILD）和T区（TzL）淋巴瘤的组织学发现和临床行为进行了研究。患者中男性74例，女性36例（年龄范围24至90岁；中位数58岁）。LeL、AILD和TzL的组织学研究显示出突出的反应性特征，这与高度恶性的T细胞淋巴瘤（多形性/免疫母细胞型）不同。对应于每种类型组织学图像的差异，临床图像和预后也存在差异。高球蛋白血症（大于4g/dl）在AILD中比在其他类型中更常见。然而，这三种类型表现出广泛多样、有时重叠的组织学表现谱，在某些情况下极难将它们彼此区分开来。它们的临床和实验室检查结果也是如此，并且与多形性/免疫母细胞性淋巴瘤相比，它们的预后相对较好。尽管传统的表型分析显示辅助/诱导性T细胞和细胞毒性/抑制性T细胞与不同程度的B细胞和组织细胞明显混合，但双重免疫组织化学研究显示肿瘤细胞主要由辅助/诱导性细胞组成。此外，5例（5%）显示出三种类型之间的形态学转变或发展为多形性/免疫母细胞性淋巴瘤。它们似乎构成了一组全面而又独特的T细胞淋巴瘤。基于形态学发现和临床数据，作者证明了以淋巴结为基础的低度T细胞淋巴瘤的独特特征以及该组中三种类型之间的关系。表型和基因型分析的结果也支持此处提出的概念。
