Casey T T, Cousar J B, Mangum M, Williams M E, Lee J T, Greer J P, Collins R D
Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee 37232.
Am J Pathol. 1990 Jan;136(1):81-94.
Patients with Hodgkin's Disease (HD) occasionally develop monomorphic lymphomas in which mononuclear cells, usually large in size, grow in sheets, and in which there are few reacting cells or classic Reed-Sternberg (RS) cells. Twelve patients of this type were reviewed to determine the nature of the monomorphic growth. Paraffin-embedded tissue sections from the original diagnostic HD and the monomorphic growths were stained for Leu-M1 (CD15), leukocyte common antigen (LCA, CD45), pan B-cell markers LN1, LN2, and L26, and pan T-cell marker UCHL1 (CD45R) reactive in paraffin-embedded tissues. Cases were included only if the original diagnostic material had the classic histopathologic features of HD, if there was a separate monomorphic growth (in place or time), and if sufficient materials from both phases were available for study. Original diagnoses of HD included nodular sclerosing (NS; 8 cases); lymphocyte predominant (LP; 2 cases); mixed cellularity (MC; 1 case); and lymphocyte depleted (LD: 1 case) types. RS cells in the eight cases of NS HD and one case of MC HD were generally Leu-M1 and LN2 positive, and L26, LN1, UCHL1, and LCA negative. RS cells in one case of NS HD were LCA positive in addition to Leu-M1, LN1, and LN2. Two cases of NS HD showed L26 positive RS cells. Conversely, RS cells and lymphocytic-histiocytic (L and H) variants in the cases of LP HD were Leu-M1 and LN2 negative, and LCA and LN1 positive. The one case of LD HD possessed RS cells that were negative for Leu-M1, but positive for LCA, L26, LN1, and LN2. In seven cases (4 NS, 2 LP, 1 LD) the monomorphic growths possessed a B-cell phenotype (LCA, L26, and LN1 positive; Leu-M1 and UCHL1 negative). In the remaining cases (4 NS, 1 MC), the monomorphic growths were Leu-M1 positive, and displayed phenotypes similar to the RS cells of the original NS HD. Southern blot analysis was performed on the monomorphic components of five cases and showed some form of immunoglobulin gene rearrangement in each (4 cases: rearranged heavy chain-joining region gene; 1 case: rearranged Mu chain-constant region gene). Two of these cases expressed L26 and LN1 in the monomorphic phases. Despite apparent immunoglobulin gene rearrangement, one case expressed T-cell antigens Leu-4 (CD3) and Leu-1 (CD5), in addition to Leu-M1 (CD15).(ABSTRACT TRUNCATED AT 400 WORDS)
霍奇金淋巴瘤（HD）患者偶尔会发展为单形性淋巴瘤，其中单核细胞通常体积较大，呈片状生长，且反应性细胞或经典的里德-施特恩伯格（RS）细胞较少。对12例这种类型的患者进行了回顾性研究，以确定单形性生长的性质。对来自最初诊断为HD的石蜡包埋组织切片以及单形性生长组织切片进行了Leu-M1（CD15）、白细胞共同抗原（LCA，CD45）、全B细胞标志物LN1、LN2和L26以及在石蜡包埋组织中有反应性的全T细胞标志物UCHL1（CD45R）染色。仅当原始诊断材料具有HD的经典组织病理学特征、存在单独的单形性生长（在部位或时间上）且两个阶段都有足够的材料用于研究时，才纳入病例。HD的原始诊断包括结节硬化型（NS；8例）；淋巴细胞为主型（LP；2例）；混合细胞型（MC；1例）；淋巴细胞消减型（LD：1例）。8例NS HD和1例MC HD中的RS细胞通常Leu-M1和LN2阳性，而L26、LN1、UCHL1和LCA阴性。1例NS HD中的RS细胞除Leu-M1、LN1和LN2外，LCA也呈阳性。2例NS HD显示L26阳性的RS细胞。相反，LP HD病例中的RS细胞和淋巴细胞-组织细胞（L和H）变异型Leu-M1和LN2阴性，LCA和LN1阳性。1例LD HD中的RS细胞Leu-M1阴性，但LCA、L26、LN1和LN2阳性。在7例（4例NS、2例LP、1例LD）中，单形性生长具有B细胞表型（LCA、L26和LN1阳性；Leu-M1和UCHL1阴性）。在其余病例（4例NS、1例MC）中，单形性生长Leu-M1阳性，且表现出与原始NS HD的RS细胞相似的表型。对5例的单形性成分进行了Southern印迹分析，结果显示每例均有某种形式的免疫球蛋白基因重排（4例：重链连接区基因重排；1例：μ链恒定区基因重排）。其中2例在单形性阶段表达L26和LN1。尽管有明显免疫球蛋白基因重排，但1例除Leu-M1（CD15）外还表达T细胞抗原Leu-4（CD3）和Leu-1（CD5）。（摘要截断于400字）
