Kataoka T, Oyama A, Suzuki H, Kurita S, Ariyoshi Y, Ota K, Suchi T, Hayashi H, Osada H, Takahashi T
Department of Hematology, Aichi Cancer Center, Nagoya.
Jpn J Clin Oncol. 1988 Dec;18(4):371-8.
A case of B-cell lymphoma of probable thymic origin is reported. A 34-year-old woman was found to have an anterior mediastinal tumor in November 1986. The surface lymph nodes were not palpable. A total resection of the tumor mass was performed. The tumor invaded the right pleura, the right lung and the pericardium. Histologically, normal thymus was found at the margin of the tumor tissue. The neoplasm was predominantly composed of large lymphoid cells, separated by rather thick fibrous bands of nodular fashion in some areas. Immunohistochemical staining demonstrated monoclonal cytoplasmic IgG and kappa chains in a small portion of the neoplastic cells in fixed tissue. The cells showed positive staining with cluster of differentiation (CD) 20 (B1) but negative staining with antibodies reactive with T-cells in unfixed tissue. "Malignant lymphoma, diffuse, large cell type (B)" was the diagnosis. The arrangements of immunoglobulin (Ig) and T cell receptor (TCR) beta genes were studied. Clonal rearrangement bands of IgH and Ig kappa genes were observed in the same sizes in both the tumor and the peripheral blood before chemotherapy. The patient received chemotherapy until September 1987, and is in complete remission at present (January 1988). The peripheral blood showed germ line patterns of IgH and Ig kappa genes in complete remission. No rearrangement bands of TCR beta genes were detected throughout. The B-cell lineage was proved both from gene arrangement analysis and with immunohistochemistry.
报告了一例可能起源于胸腺的B细胞淋巴瘤病例。1986年11月，一名34岁女性被发现患有前纵隔肿瘤。未触及浅表淋巴结。对肿瘤肿块进行了全切除。肿瘤侵犯了右胸膜、右肺和心包。组织学检查发现肿瘤组织边缘有正常胸腺。肿瘤主要由大淋巴细胞组成，在某些区域被相当厚的结节状纤维带分隔。免疫组织化学染色显示固定组织中一小部分肿瘤细胞中有单克隆细胞质IgG和κ链。在未固定组织中，细胞对分化簇（CD）20（B1）呈阳性染色，但对与T细胞反应的抗体呈阴性染色。诊断为“恶性淋巴瘤，弥漫性，大细胞型（B）”。研究了免疫球蛋白（Ig）和T细胞受体（TCR）β基因的排列。化疗前，肿瘤和外周血中均观察到大小相同的IgH和Igκ基因的克隆重排带。该患者接受化疗至1987年9月，目前（1988年1月）处于完全缓解状态。完全缓解时外周血显示IgH和Igκ基因的胚系模式。整个过程未检测到TCRβ基因的重排带。通过基因排列分析和免疫组织化学均证实了B细胞系。
