Institute of Pathology, University Hospital Basel, Basel, Switzerland.
Histol Histopathol. 2012 Aug;27(8):1013-20. doi: 10.14670/HH-27.1013.
Lymphomas encompass a broad spectrum of neoplasias. Traditionally it has been assumed that recurrent neoplasia, especially lymphoma, represents a relapse of the original clone. However, this concept has been challenged. Here we present an overview of novel perceptions regarding the clonal relationship of relapsing lymphoid neoplasms, i.e. precursor cell acute lymphoblastic lymphoma/leukemia (ALL), so called non-Hodgkin lymphomas (NHL) and classical Hodgkin lymphoma (cHL) and discuss the potential implications of these findings. In ALL, approximately 10% of "relapses" were found to be clonally unrelated to the original disease. In NHL, small series and case reports showed the occurrence of meta- or synchronous lymphoid malignancies, which were of different clonal origin. In cHL, there is evidence that both early and late "relapses" may constitute to a certain proportion a novel neoplasm of different clonal origin too. These findings warrant further investigations in order to verify and strengthen the existing data and might have important clinical implications because novel clonally unrelated lymphomas imitating relapses could possibly be treatable with less aggressive regimens compared to true recurrences.
淋巴瘤包含了广泛的肿瘤谱。传统上，人们一直认为复发性肿瘤，特别是淋巴瘤，代表了原始克隆的复发。然而，这一概念受到了挑战。在这里，我们概述了关于复发性淋巴肿瘤克隆关系的新认识，即前体细胞急性淋巴细胞白血病/淋巴瘤（ALL）、所谓的非霍奇金淋巴瘤（NHL）和经典霍奇金淋巴瘤（cHL），并讨论了这些发现的潜在意义。在 ALL 中，约有 10%的“复发”被发现与原始疾病无克隆相关性。在 NHL 中，一些小系列和病例报告显示了不同克隆起源的继发或同步淋巴恶性肿瘤的发生。在 cHL 中，有证据表明，早期和晚期的“复发”在一定程度上也可能是由不同克隆起源的新肿瘤组成。这些发现需要进一步研究，以验证和加强现有的数据，因为模仿复发的新型无克隆相关性淋巴瘤可能可以用比真正复发更不激进的方案治疗。
