Nizze H, Cogliatti S B, von Schilling C, Feller A C, Lennert K
Department of Pathology, University of Kiel, Germany.
Histopathology. 1991 May;18(5):403-14. doi: 10.1111/j.1365-2559.1991.tb00870.x.
Twenty-eight cases of monocytoid B-cell lymphoma of lymph nodes and 16 lymph node metastases of primary gastric lymphomas, mostly low-grade B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) type were investigated morphologically and immunohistochemically. Both groups showed the same morphological and immunohistochemical features: diagnostically important sites of infiltration were the sinuses and the marginal zones. The tumour cells were either medium-sized or small. The cytoplasm stained grey with Giemsa and was sometimes rather pale. In imprints the grey colour of the cytoplasm was a characteristic feature. The medium-sized cell type was more frequent; in one third of the cases it was combined with a prominent lymphoplasmacytic component from the same clone, and it resembled the monocytoid B-cells of the sinuses. The small cell type was less common, was not combined with a lymphoplasmacytic component and more closely resembled marginal zone cells. The difference was underlined by the negative reaction with the monoclonal antibody Ki-B3 in the small cell type, which, conversely, was positive in the medium-sized cell type and in the monocytoid B-cell reaction of the sinuses. Both of these cell types, however, showed a granular reaction with the new monoclonal antibody Ki-Mlp. The morphological and immunohistochemical parallels are arguments in favour of the assumption that monocytoid B-cell lymphoma is the nodal equivalent of low-grade B-cell lymphoma of MALT type. This is further supported by the fact that in nine of our 28 cases of monocytoid B-cell lymphoma, lymphomas were found simultaneously or subsequently in organs of the MALT. Monocytoid B-cell lymphoma must be differentiated from an infiltration that occurs in the form of clusters of monocytoid B-cells in other low-grade B-cell lymphomas, especially in immunocytoma with a high content of epithelioid cells.
对28例淋巴结单核细胞样B细胞淋巴瘤及16例原发性胃淋巴瘤的淋巴结转移灶进行了形态学和免疫组织化学研究，这些病例大多为黏膜相关淋巴组织（MALT）型的低级别B细胞淋巴瘤。两组病例均表现出相同的形态学和免疫组织化学特征：具有诊断意义的浸润部位为窦和边缘区。肿瘤细胞为中等大小或小细胞。吉姆萨染色显示细胞质呈灰色，有时较淡。印片中细胞质的灰色是其特征性表现。中等大小细胞类型更为常见；在三分之一的病例中，它与来自同一克隆的显著淋巴浆细胞成分并存，且类似于窦内的单核细胞样B细胞。小细胞类型较少见，不与淋巴浆细胞成分并存，更类似于边缘区细胞。小细胞类型对单克隆抗体Ki-B3呈阴性反应，而中等大小细胞类型及窦内的单核细胞样B细胞反应则呈阳性，这凸显了两者的差异。然而，这两种细胞类型对新的单克隆抗体Ki-Mlp均呈颗粒状反应。形态学和免疫组织化学上的相似之处支持了单核细胞样B细胞淋巴瘤是MALT型低级别B细胞淋巴瘤的淋巴结对应物这一假设。我们的28例单核细胞样B细胞淋巴瘤中有9例在MALT器官中同时或随后发现淋巴瘤，这一事实进一步支持了该假设。单核细胞样B细胞淋巴瘤必须与其他低级别B细胞淋巴瘤中以单核细胞样B细胞簇形式出现的浸润相鉴别，尤其是在上皮样细胞含量高的免疫细胞瘤中。
