Gao Xue, Huang Wenyong, Li Wensheng, Xie Jianlan, Zheng Yuanyuan, Zhou Xiaoge
Beijing Firendship Hospital, Capital Medical University, Beijing 100050, China.
Department of Pathology, Jiujiang University Hospital, Jiujiang 332000, China.
Zhonghua Bing Li Xue Za Zhi. 2015 Aug;44(8):553-8.
To study the clinicopathologic features and pathologic diagnosis and differential diagnosis of angioimmunoblastic T-cell lymphoma with HRS-like cells.
Six cases of angioimmunoblastic T-cell lymphoma with HRS-like cells were examined histologically and immunohistochemically (EliVision method) and in-situ hybridization for Epstein-Barr virus-encoded RNA (EBER), and the literature was reviewed.
The cytologic and microscopic features of these imprints and lymph node samples showed a heterogeneous population of hematolymphoid cells, including small to intermediate lymphoid cells, immunoblasts, plasma cells, dendritic cells, and eosinophils, as well as small vessels that were surrounded by some of the abnormal cells. The neoplastic T-cells expressed CD3 and CD5 and partly positive for CD10 and bcl-6, CD21 showed expanded and irregular follicular dendritic cell (FDC) meshworks that surrounding the high HEV. The HRS-like cells were positive for MUM-1 and Ki-67, variable intensity positive for CD30, CD20, and PAX-5, but negative for CD15. EBV-positive cells included HRS-like cells and small to large-sized neoplastic T-cells, which formed small clusters or scattering in the background of the disease.
The clinical course of angioimmunoblastic T-cell lymphoma with HRS-like cells is aggressive. Which present with histomorphology overlap with classical Hodgkin lymphoma (CHL), similar to CHL in EBER and immunophenotype, however, it is easy to misdiagnosis as HL. Thus, angioimmunoblastic T-cell lymphoma pathology diagnosis should comprehensive analysis of different kinds of materials, including clinical features, and histological structure, and EBER, and immunophenotype, and gene rearrangement.
研究伴有霍奇金/里德-斯腾伯格（HRS）样细胞的血管免疫母细胞性T细胞淋巴瘤的临床病理特征及病理诊断与鉴别诊断。
对6例伴有HRS样细胞的血管免疫母细胞性T细胞淋巴瘤进行组织学、免疫组织化学（EliVision法）及爱泼斯坦-巴尔病毒编码RNA（EBER）原位杂交检测，并复习相关文献。
这些印片及淋巴结样本的细胞学和显微镜特征显示为异质性的血液淋巴样细胞群体，包括小至中等大小的淋巴细胞、免疫母细胞、浆细胞、树突状细胞和嗜酸性粒细胞，以及一些异常细胞围绕的小血管。肿瘤性T细胞表达CD3和CD5，部分CD10和bcl-6呈阳性，CD21显示围绕高内皮静脉（HEV）的滤泡树突状细胞（FDC）网络扩张且不规则。HRS样细胞MUM-1和Ki-67呈阳性，CD30、CD20和PAX-5呈不同强度阳性，但CD15呈阴性。EBV阳性细胞包括HRS样细胞及小至大的肿瘤性T细胞，它们在病变背景中形成小簇或散在分布。
伴有HRS样细胞的血管免疫母细胞性T细胞淋巴瘤临床过程具有侵袭性。其组织形态学与经典霍奇金淋巴瘤（CHL）有重叠，EBER及免疫表型与CHL相似，但易误诊为HL。因此，血管免疫母细胞性T细胞淋巴瘤的病理诊断应综合分析包括临床特征、组织结构、EBER、免疫表型及基因重排等不同材料。
