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结外弥漫性大 B 细胞淋巴瘤,皮肤滤泡中心淋巴瘤型:24 例非皮肤原发性局限性结外弥漫性大 B 细胞淋巴瘤患者的研究支持新概念。

Extranodal diffuse large B cell lymphoma of cutaneous follicle centre lymphoma type: a study of 24 patients with non-cutaneous primary limited stage extranodal diffuse large B cell lymphoma in support of a new concept.

机构信息

Department of Pathology, University Hospital Zurich, Zurich, Switzerland.

出版信息

Histopathology. 2012 Apr;60(5):774-84. doi: 10.1111/j.1365-2559.2011.04122.x. Epub 2012 Feb 3.

Abstract

AIMS

Follicle centre cell lymphoma of small cell type showing either a follicular or diffuse growth pattern similar to cutaneous follicle centre lymphoma (cFCL) has been recognized in extranodal non-cutaneous sites. Our aim was (i) to investigate whether diffuse large B cell lymphoma (DLBCL) of cFCL type could be identified in extranodal non-cutaneous sites and (ii) whether clinical characteristics similar to primary cFCL could be recognized.

METHODS AND RESULTS

Of 24 extranodal non-cutaneous DLBCLs, nine (38%) had large centrocytoid morphology and 15 (62%) were either 'centrocytoid and centroblastic' or 'centroblastic and immunoblastic'. Six centrocytoid cases were Irf-4 negative, Bcl-6 positive and at most weakly CD10- or Bcl-2-positive by immunohistochemistry, consistent with DLBCL of cFCL type. All patients with cFCL type were stage IE and were significantly younger than other patients. Recurrences occurred in two patients and were exclusively extranodal.

CONCLUSION

Our results suggest that DLBCL of cFCL type can be identified in extranodal non-cutaneous sites and shows clinical characteristics similar to genuine cFCL. We propose to expand the concept of cFCL to encompass large cell lymphomas in extranodal sites.

摘要

目的

在结外非皮肤部位已经认识到了小细胞型滤泡中心细胞淋巴瘤,其表现为类似于皮肤滤泡中心淋巴瘤(cFCL)的滤泡或弥漫生长模式。我们的目的是(i)研究在结外非皮肤部位是否可以识别出类似于 cFCL 的弥漫性大 B 细胞淋巴瘤(DLBCL),以及(ii)是否可以识别出类似于原发性 cFCL 的临床特征。

方法和结果

在 24 例结外非皮肤 DLBCL 中,有 9 例(38%)具有大中心细胞形态,有 15 例(62%)为“中心细胞和中心母细胞”或“中心母细胞和免疫母细胞”。6 例中心细胞病例的 Irf-4 阴性,Bcl-6 阳性,免疫组化染色最多弱阳性 CD10 或 Bcl-2 阳性,与 cFCL 型的 DLBCL 一致。所有 cFCL 型患者均为 IE 期,且明显比其他患者年轻。2 例患者出现复发,且均为结外复发。

结论

我们的结果表明,cFCL 型的 DLBCL 可以在结外非皮肤部位识别,并且表现出与真正的 cFCL 相似的临床特征。我们建议将 cFCL 的概念扩展到包括结外部位的大细胞淋巴瘤。

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