Institute of Pathology and Comprehensive Cancer Center (CCC), University of Tübingen, Tübingen, Germany.
Mod Pathol. 2012 Dec;25(12):1629-36. doi: 10.1038/modpathol.2012.117. Epub 2012 Jul 13.
Recently, the occurrence of cyclin D1-positive B cells with mantle cell lymphoma phenotype in the inner mantle zones of morphologically inconspicuous lymph nodes has been described and termed mantle cell lymphoma 'in situ'. Prevalence and clinical significance of this lesion and related minimal mantle cell lymphoma infiltrates in reactive lymphoid tissues of healthy individuals, and of mantle cell lymphoma patients are unknown. All 1292 reactive lymph nodes from unselected consecutive surgical specimens of 131 patients without a history of lymphoma obtained over a 3-month period were stained for cyclin D1. In addition, all morphologically reactive lymph nodes and benign-appearing extranodal lymphoid infiltrates of patients diagnosed with mantle cell lymphoma in the years 2000-2011 were studied. Samples predating the lymphoma diagnosis for at least 2 months were available from 37/423 (9%) patients. A mantle cell lymphoma 'in situ' was not identified in any of the two groups. However, in four patients with subsequent mantle cell lymphoma diagnosis, an early manifestation of mantle cell lymphoma was detected retrospectively, antedating the lymphoma diagnosis for 2-86 months. In six mantle cell lymphoma patients, only small groups of cyclin D1-positive cells in morphologically reactive extranodal infiltrates were detected >2 months before the diagnosis of mantle cell lymphoma (range 3-59 months). Mantle cell lymphoma 'in situ' is an extremely rare phenomenon in morphologically reactive lymph nodes, in line with the low prevalence of t(11;14)-positive cells described in the peripheral blood of a healthy population. In mantle cell lymphoma patients, however, immunohistochemically detectable infiltrates of mantle cell lymphoma cells antedating the lymphoma diagnosis were found in a significant proportion of cases (10/37=27%). These consisted either of early mantle cell lymphoma with mantle zone growth pattern, or small extranodal accumulations of cyclin D1+ cells, whereas typical mantle cell lymphoma 'in situ' was not detected.
最近，在形态上不明显的淋巴结的内套区中出现了具有套细胞淋巴瘤表型的 cyclin D1 阳性 B 细胞，并将其命名为“原位”套细胞淋巴瘤。这种病变以及相关的微小套细胞淋巴瘤浸润在健康个体的反应性淋巴组织中以及套细胞淋巴瘤患者中的患病率和临床意义尚不清楚。在为期 3 个月的时间内，从 131 名无淋巴瘤病史的连续手术标本中选择了 1292 个反应性淋巴结，对其进行 cyclin D1 染色。此外，研究了 2000 年至 2011 年期间诊断为套细胞淋巴瘤的所有形态学反应性淋巴结和良性表现的结外淋巴组织浸润。对于 37/423（9%）名患者，至少有 2 个月的淋巴瘤诊断前样本可用。在这两个组中均未发现“原位”套细胞淋巴瘤。然而，在随后诊断为套细胞淋巴瘤的 4 名患者中，回顾性地检测到了套细胞淋巴瘤的早期表现，比淋巴瘤诊断提前了 2-86 个月。在 6 名套细胞淋巴瘤患者中，在诊断为套细胞淋巴瘤前 2 至 59 个月（范围 3-59 个月），仅在形态学上反应性的结外浸润中检测到少数 cyclin D1 阳性细胞。“原位”套细胞淋巴瘤在形态学上反应性淋巴结中是一种极为罕见的现象，与健康人群外周血中描述的 t（11；14）阳性细胞的低患病率一致。然而，在套细胞淋巴瘤患者中，在相当比例的病例中发现了免疫组化可检测到的套细胞淋巴瘤细胞浸润，早于淋巴瘤诊断（10/37=27%）。这些要么是早期具有套区生长模式的套细胞淋巴瘤，要么是 cyclin D1+细胞的小结外积聚，而未检测到典型的“原位”套细胞淋巴瘤。
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