Probatova N A
Arkh Patol. 1990;52(9):72-5.
On the basis of morphoimmunological correlates certain criteria have been elaborated helpful in diagnosis of non-Hodgkin's malignant lymphomas (NML) of both B- and T-cell origin, and this was reflected in the modified Kiel's classification. The group of T-cell NML has considerably increased. T-cell origin of Lennert's lymphoma and angioimmunoblastic lymphadenopathy has been proven. Morphological substrate of NML from peripheral T-lymphocytes became more precise. The tumours, depending on the predominant cells, are subdivided into small cell (T-zones and pleomorphic lymphoma of small cells), mixed cell (pleomorphic lymphoma of medium-size and large cells) and large cell lymphoma (immunoblastic and large cell anaplastic Ki-I+). Criticism of T-NML systematization is due to the lack of definite cytological criteria because of the extreme morphological heterogeneity of peripheral T-lymphocytes and different interpretation of the clinical course of the established morphological variants. Among B-cell lymphomas the problem of the so-called intermediate lymphocytic lymphoma (ILL) and its variety--a mantle-zone lymphoma as well as monocytoid B-cell lymphoma is discussed in the literature. It is established in immunological testing that the cells of ILL possess a phenotype of cells of the primary follicles and those of the mantle-zone of the secondary follicles while the cells of the monocytoid B-cell NML have a peculiar unique phenotype similar to that of cells in the marginal zone of the spleen follicles.
基于形态免疫相关性,已制定了某些有助于诊断B细胞和T细胞起源的非霍奇金恶性淋巴瘤(NML)的标准,这在改良的基尔分类中得到了体现。T细胞NML组有了显著增加。已证实 Lennert 淋巴瘤和血管免疫母细胞性淋巴结病起源于T细胞。外周T淋巴细胞来源的NML的形态学基础变得更加精确。根据主要细胞类型,肿瘤可分为小细胞型(T区和小细胞多形性淋巴瘤)、混合细胞型(中、大细胞多形性淋巴瘤)和大细胞淋巴瘤(免疫母细胞性和大细胞间变性Ki-I+)。对T-NML系统化的批评在于缺乏明确的细胞学标准,因为外周T淋巴细胞形态极度异质性以及对既定形态学变异临床过程的不同解读。在B细胞淋巴瘤中,文献中讨论了所谓的中等淋巴细胞淋巴瘤(ILL)及其变体——套区淋巴瘤以及单核细胞样B细胞淋巴瘤的问题。免疫检测确定,ILL细胞具有初级滤泡细胞和次级滤泡套区细胞的表型,而单核细胞样B细胞NML的细胞具有与脾滤泡边缘区细胞相似的独特表型。