Yanagihara E T, Blaisdell R K, Hayashi T, Lukes R J
Department of Pathology, Kuakini Medical Center, Honolulu, Hawaii 96817.
Hematol Oncol. 1989 May-Jun;7(3):219-32. doi: 10.1002/hon.2900070305.
A retrospective morphologic survey (1973-1983) of 146 cases of malignant lymphoma among the Hawaii-Japanese (migrant Japanese and their offspring) was conducted to determine whether differences in the incidence and cytologic types of malignant lymphoma exist when compared to those of native Japanese (lifetime residents of Japan). The age-adjusted incidence rates for malignant lymphoma among the Hawaii-Japanese were similar to rates for U.S. whites. However, higher rates for follicular centre cell (FCC) lymphoma with a follicular pattern were observed in the Hawaii-Japanese population when compared with rates for native Japanese. On the basis of the cytologic types of the Lukes-Collins classification, non-Hodgkin's lymphomas among the Hawaii-Japanese resembled those of Western countries, rather than those of Japan. B-cell lymphomas predominated (72 per cent), while T-cell types comprised 23 per cent of cases. Follicular centre cell types were encountered most often (59 per cent), and the small cleaved FCC subtype was the most common (30 per cent). The high degree of follicularity (29 per cent) was at variance with the consistently low rates reported in Japan. This may be explained, in part, by higher rates of nodal lymphomas among the Hawaii-Japanese. Of the T-cell lymphomas, diffuse large cell types (T-cell immunoblastic sarcoma, T-IBS), often with cytologic pleomorphism, were relatively frequently encountered (16 per cent), and comprised 15 per cent of non-Hodgkin's lymphomas; this observation necessitates special clinical and epidemiologic consideration in view of the large Japanese migration to Hawaii from HTLV-I endemic regions of southern Japan. No registered cases of non-Hodgkin's lymphoma or of Hodgkin's disease were documented in Hawaii-Japanese subjects under the age of 15 years. The age-adjusted incidence rates for Hodgkin's disease among the Hawaii-Japanese were similar with those of native Japanese. Nodular sclerosis was the most frequent histologic subtype. The difficulty in distinguishing between Hodgkin's disease and non-Hodgkin's lymphoma, particularly when immunologic cell surface markers are not available, is addressed. Low rates for chronic lymphocytic leukemia among the Hawaii-Japanese were confirmed. Not one well-documented case was identified in the 11-year period surveyed.
对146例夏威夷日裔（移民日本人和他们的后代）恶性淋巴瘤患者进行了一项回顾性形态学调查（1973 - 1983年），以确定与日本本土居民（日本终身居民）相比，恶性淋巴瘤的发病率和细胞学类型是否存在差异。夏威夷日裔中恶性淋巴瘤的年龄调整发病率与美国白人相似。然而，与日本本土居民相比，夏威夷日裔人群中具有滤泡型的滤泡中心细胞（FCC）淋巴瘤发病率更高。根据卢克斯 - 柯林斯分类的细胞学类型，夏威夷日裔中的非霍奇金淋巴瘤与西方国家相似，而非日本。B细胞淋巴瘤占主导（72%），而T细胞类型占病例的23%。滤泡中心细胞类型最常出现（59%），小裂FCC亚型最常见（30%）。高度滤泡化（29%）与日本报道的持续低发病率不同。这部分可以通过夏威夷日裔中淋巴结淋巴瘤的较高发病率来解释。在T细胞淋巴瘤中，弥漫性大细胞类型（T细胞免疫母细胞肉瘤，T - IBS），通常伴有细胞学多形性，相对频繁出现（16%），占非霍奇金淋巴瘤的15%；鉴于大量日本人从日本南部HTLV - I流行地区迁移到夏威夷，这一观察结果需要特殊的临床和流行病学考虑。在15岁以下的夏威夷日裔受试者中，未记录到非霍奇金淋巴瘤或霍奇金病的登记病例。夏威夷日裔中霍奇金病的年龄调整发病率与日本本土居民相似。结节硬化是最常见的组织学亚型。文中讨论了区分霍奇金病和非霍奇金淋巴瘤的困难，特别是在没有免疫细胞表面标志物的情况下。证实了夏威夷日裔中慢性淋巴细胞白血病的发病率较低。在调查的11年期间未发现一例记录完善的病例。
