Frizzera G, Anaya J S, Banks P M
Virchows Arch A Pathol Anat Histopathol. 1986;409(2):149-62. doi: 10.1007/BF00708324.
Six cases of follicular lymphoma contained an abundant plasma cell component. With immunoperoxidase techniques, this was found to demonstrate monotypic cytoplasmic marking for either K or L Ig light chain in five cases, and for IgA heavy chain only in one case. A histogenetic relationship between follicular center cells and plasma cells was suggested by cell forms morphologically intermediate between these two types and by monotypic plasma cells in the neoplastic follicles. The progressive differentiation of follicular center cells into Ig-secreting cells in these cases is likely to be the result of an alteration of the immunoregulatory mechanisms that usually block the differentiation of follicular lymphomas. Four of our patients presented with disseminated disease, three had extranodal presentation and four manifested serum paraproteins. Their median survival was 40 months; two of them died of disease. The published data and our own suggest that follicular lymphoma with plasmacytic differentiation is a malignancy of intermediate grade, with survival and clinical features closer to lymphoplasmacytic/lymphoplasmacytoid lymphoma (LP immunocytoma) than to follicular lymphoma.
6例滤泡性淋巴瘤含有丰富的浆细胞成分。采用免疫过氧化物酶技术检测发现，5例浆细胞成分呈K或L Ig轻链单型胞质标记，仅1例呈IgA重链单型胞质标记。这两种细胞形态学上的中间形式以及肿瘤滤泡中的单型浆细胞提示滤泡中心细胞与浆细胞之间存在组织发生学关系。在这些病例中，滤泡中心细胞逐渐分化为Ig分泌细胞，可能是由于通常阻止滤泡性淋巴瘤分化的免疫调节机制发生改变所致。我们的4例患者表现为播散性疾病，3例为结外表现，4例出现血清副蛋白。他们的中位生存期为40个月；其中2例死于该疾病。已发表的数据以及我们自己的研究表明，伴有浆细胞分化的滤泡性淋巴瘤是一种中度恶性肿瘤，其生存期和临床特征更接近淋巴浆细胞性/淋巴浆细胞样淋巴瘤（LP免疫细胞瘤），而非滤泡性淋巴瘤。
