Dumont J, Thiéry J P, Mazabraud A
Nouv Rev Fr Hematol (1978). 1979;21(3):257-82.
Angioimmunoblastic lymphadenopathy (AIL) has been clinically and histopathologically described by several authors since 1972, but only a few papers have analyzed the morphological aspects of the lymph nodes as observed by using electron microscopy. In the past three years, we happened to see in the Curie Institute two typical cases of AIL, both of whose clinical and immunological data are briefly reported in this paper. We describe some peculiar patterns observed on the lymph nodes during the acute phase of the disease, by examination of semithin sections and electron-microscopic preparations. As have many others, we found strong diffuse B-lymphocyte proliferation, but we must emphasize that many plasmocytes had an obvious defect in cell maturation, but no monomorphous defect. We noted that the predominant postcapillary venules had hypertrophied endothelial and perithelial cells, and multilayering basal lamina. We found some unusual features such as lymphocyte and/or plasmocyte phagocytosis by macrophages, or the atypical aspect of eosinophilic granulations. Finally, in the cytoplasm of a few transformed lymphocytes we detected some viral-like particles resembling herpes virus. Whether this last finding may have been related to the pathogeny of AIL could not be resolved by using morphological techniques. In the second part of this paper, we discuss the etiology of the disease, taking in account our clinical, immunological, and morphological observations. The possible relation of AIL to infectious mononucleosis, and the hypothetical role of Epstein-Barr virus are discussed.
自1972年以来，已有多位作者从临床和组织病理学方面对血管免疫母细胞性淋巴结病（AIL）进行了描述，但仅有少数论文分析了利用电子显微镜观察到的淋巴结形态学特征。在过去三年中，我们在居里研究所碰巧遇到了两例典型的AIL病例，本文简要报告了这两例病例的临床和免疫学数据。通过对半薄切片和电子显微镜标本的检查，我们描述了在疾病急性期淋巴结上观察到的一些特殊模式。和其他许多人一样，我们发现有强烈的弥漫性B淋巴细胞增殖，但必须强调的是，许多浆细胞在细胞成熟方面存在明显缺陷，但并非单一形态缺陷。我们注意到，主要的毛细血管后微静脉有肥大的内皮细胞和周皮细胞，以及多层基膜。我们发现了一些不寻常的特征，如巨噬细胞对淋巴细胞和/或浆细胞的吞噬作用，或嗜酸性颗粒的非典型形态。最后，在少数转化淋巴细胞的细胞质中，我们检测到了一些类似疱疹病毒的病毒样颗粒。利用形态学技术无法确定这一最新发现是否与AIL的发病机制有关。在本文的第二部分，我们结合临床、免疫学和形态学观察结果，讨论了该疾病的病因。还讨论了AIL与传染性单核细胞增多症的可能关系，以及爱泼斯坦-巴尔病毒的假设作用。
