Patsouris E, Noël H, Lennert K
Institute of Pathology, University of Athens, Greece.
Am J Surg Pathol. 1988 May;12(5):341-50. doi: 10.1097/00000478-198805000-00002.
Four hundred and two cases considered or suspected to be lymphoepithelioid cell lymphoma (Lennert's lymphoma) were analyzed morphologically, immunohistochemically, and clinically. One hundred and eight of these cases, investigated in 180 biopsies, fulfilled the morphological and immunohistochemical criteria for lymphoepithelioid cell lymphoma and are herein reported. Cellular composition and histological structure are described in detail as a basis for discriminating Lennert's lymphoma from similar lymphomas with a high content of epithelioid cells (Hodgkin's disease, AILD type of T-cell lymphoma, lymphoplasmacytic lymphoma) and from inflammatory epithelioid cell reactions. Single typical Hodgkin cells were found in only 3.8% of biopsy specimens examined, and single typical Sternberg-Reed cells were found in only 2.2% of the biopsy specimens examined. Because these single Hodgkin and Sternberg-Reed cells were situated in a relatively monotonous lymphoid cellular pattern and because both these cells types also may occur in peripheral T-cell lymphomas, we include cases with such cells in the category of Lennert's lymphoma. Eight percent of the patients with lymphoepithelioid cell lymphoma showed transformation into a large-cell T-cell lymphoma without the prominent focal epithelioid cell component previously observed. Immunohistochemically, seven of the 69 biopsy specimens with detectable giant cells stained positively for the granulocyte-specific monoclonal antibody 3C4 (approximately CD15). Plasma cells were rare and always showed a polytypic immunoglobulin pattern. Lymphoepithelioid cell lymphoma, defined as a lymphoma of CD4+ T lymphocytes, marks the border between Hodgkin's disease and the non-Hodgkin's lymphomas. Today, absolute criteria for distinguishing between these two classes of lymphoma are lacking.
对402例被认为或疑似为淋巴上皮样细胞淋巴瘤（ Lennert淋巴瘤）的病例进行了形态学、免疫组织化学和临床分析。其中108例经180次活检，符合淋巴上皮样细胞淋巴瘤的形态学和免疫组织化学标准，现予以报道。详细描述了细胞组成和组织结构，作为鉴别Lennert淋巴瘤与具有高上皮样细胞含量的相似淋巴瘤（霍奇金病、AILD型T细胞淋巴瘤、淋巴浆细胞淋巴瘤）以及与炎症性上皮样细胞反应的基础。在所检查的活检标本中，仅3.8%发现单个典型的霍奇金细胞，仅2.2%发现单个典型的Sternberg-Reed细胞。由于这些单个的霍奇金细胞和Sternberg-Reed细胞位于相对单一的淋巴细胞模式中，并且这两种细胞类型也可能出现在外周T细胞淋巴瘤中，因此我们将有此类细胞的病例归入Lennert淋巴瘤类别。8%的淋巴上皮样细胞淋巴瘤患者转变为大细胞T细胞淋巴瘤，且无先前观察到的突出局灶性上皮样细胞成分。免疫组织化学方面，69例可检测到巨细胞的活检标本中有7例对粒细胞特异性单克隆抗体3C4（约CD15）呈阳性染色。浆细胞罕见，且总是呈现多型免疫球蛋白模式。淋巴上皮样细胞淋巴瘤被定义为CD4+T淋巴细胞淋巴瘤，标志着霍奇金病和非霍奇金淋巴瘤之间的界限。如今，缺乏区分这两类淋巴瘤的绝对标准。
