Kunder Christian, Cascio Michael J, Bakke Anthony, Venkataraman Girish, O'Malley Dennis P, Ohgami Robert S
From Stanford University, Stanford, CA.
Oregon Health and Science University, Portland.
Am J Clin Pathol. 2017 Jun 1;147(6):596-603. doi: 10.1093/ajcp/aqx034.
T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is a morphologic variant of large B-cell lymphoma whose flow cytometry findings are not well characterized.
Nineteen cases with flow cytometric immunophenotyping were identified from the case records of four institutions between 2001 and 2016.
In most cases, neoplastic B cells were not detected by flow cytometry. Overall, cases showed a predominance of CD4+ T cells, which in some cases was marked. Significant coexpression of CD57 was seen on CD4+ T cells where this marker was analyzed, which correlated with PD-1 expression. Two cases also showed a profound systemic B-cell lymphopenia, which was associated in one case with hypogammaglobulinemia.
Overall, our work challenges previous findings that cases of THRLBCL are rich in CD8+ T cells and highlights parallels between THRLBCL and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL). Also, an association of THRLBCL with systemic B-cell lymphopenia has not been previously reported but may represent an underrecognized manifestation.
富于T细胞/组织细胞的大B细胞淋巴瘤（THRLBCL）是大B细胞淋巴瘤的一种形态学变异型，其流式细胞术检测结果尚未得到充分描述。
从2001年至2016年期间四个机构的病例记录中确定了19例进行流式细胞术免疫表型分析的病例。
在大多数病例中，流式细胞术未检测到肿瘤性B细胞。总体而言，病例显示CD4 + T细胞占优势，在某些病例中这种优势很明显。在分析该标志物的情况下，CD4 + T细胞上可见CD57的显著共表达，这与PD-1表达相关。两例还表现出严重的全身性B细胞淋巴细胞减少，其中一例与低丙种球蛋白血症有关。
总体而言，我们的研究对先前关于THRLBCL病例富含CD8 + T细胞的研究结果提出了挑战，并突出了THRLBCL与结节性淋巴细胞为主型霍奇金淋巴瘤（NLPHL）之间的相似之处。此外，THRLBCL与全身性B细胞淋巴细胞减少的关联此前尚未见报道，但可能是一种未被充分认识的表现。
