Tumwine Lynnette K, Campidelli Cristina, Righi Simona, Neda Sophia, Byarugaba Wilson, Pileri Stefano A
Department of Pathology, Makerere University Medical School, PO Box 7072, Kampala, Uganda.
Hum Pathol. 2008 Jun;39(6):817-23. doi: 10.1016/j.humpath.2007.10.025. Epub 2008 Apr 23.
The most common non-Hodgkin lymphomas in Uganda are neoplasms of B-cell derivation. The field of B-cell lymphoma immunophenotype has rapidly progressed because of the increasing availability of markers applicable to routine sections. Although the latter have allowed the identification of distinctive lymphoma entities in the developed countries, such approach has not yet been used in Uganda. One hundred twenty-nine formalin-fixed, paraffin-embedded tissue samples from the Department of Pathology of Makerere University were used for tissue micro-array (TMA) construction. Four-micrometer-thick sections were cut from TMAs and stained with hematoxylin and eosin and Giemsa. They were also used for immunohistochemistry and in situ hybridization. According to morphology and immunohistochemistry, lymphoid neoplasms were classified as Burkitt's lymphoma (BL) (95 cases), diffuse large B-cell lymphoma (19 cases), mantle cell lymphoma (4 cases), and B-cell lymphoblastic lymphoma (1 case). In BL, a homogeneous phenotype (CD10(+), Bcl-6(+), Bcl-2(-), MUM1/IRF4-, and Ki-67 approximately 100%) and a stable Epstein-Barr virus integration were found. A distinctive and unusual feature was the frequent plasma cellular differentiation, along with the positivity for CD30 and CD138 (recorded in 35 and 43 cases, respectively). According to our findings, most non-Hodgkin B-cell tumors in Uganda are endemic BLs followed by diffuse large B-cell lymphomas. The rest consist of rare but clinically important entities such as mantle cell lymphoma and B-cell lymphoblastic lymphoma. The availability of TMAs and immunohistochemistry has enabled us to precisely categorize tumors that have so far been diagnosed in Uganda as "high-grade/aggressive" lymphomas on the basis of cell morphology alone.
乌干达最常见的非霍奇金淋巴瘤是B细胞来源的肿瘤。由于适用于常规切片的标志物越来越多，B细胞淋巴瘤免疫表型领域发展迅速。尽管后者已使发达国家能够识别出独特的淋巴瘤实体，但这种方法尚未在乌干达使用。取自马凯雷雷大学病理系的129份福尔马林固定、石蜡包埋的组织样本用于构建组织微阵列（TMA）。从TMA上切下4微米厚的切片，用苏木精和伊红以及吉姆萨染色。它们还用于免疫组织化学和原位杂交。根据形态学和免疫组织化学，淋巴样肿瘤被分类为伯基特淋巴瘤（BL）（95例）、弥漫性大B细胞淋巴瘤（19例）、套细胞淋巴瘤（4例）和B细胞淋巴母细胞淋巴瘤（1例）。在BL中，发现了一种均匀的表型（CD10(+)、Bcl-6(+)、Bcl-2(-)、MUM1/IRF4-，且Ki-67约为100%）以及稳定的爱泼斯坦-巴尔病毒整合。一个独特且不寻常的特征是频繁的浆细胞分化，同时伴有CD30和CD138阳性（分别记录于35例和43例）。根据我们的研究结果，乌干达大多数非霍奇金B细胞肿瘤是地方性BL，其次是弥漫性大B细胞淋巴瘤。其余包括罕见但临床上重要的实体，如套细胞淋巴瘤和B细胞淋巴母细胞淋巴瘤。TMA和免疫组织化学的可用性使我们能够根据细胞形态学，将乌干达迄今诊断为“高级别/侵袭性”淋巴瘤的肿瘤精确分类。
