Blaustein J C, Lewkow L
Hum Pathol. 1987 Jul;18(7):746-8. doi: 10.1016/s0046-8177(87)80247-2.
A case of recurrent Hodgkin's disease of the "sarcomatoid" or "syncytial variant" type was seen that occurred as an extension from the mediastinum to a previously uninvolved extranodal site (breast) and pericardium after treatment of classical nodular sclerosing Hodgkin's disease based in the lymph nodes. This histologic variant was composed of sheets of large, undifferentiated neoplastic cells with few, if any, diagnostic features of nodular sclerosing Hodgkin's disease. For this reason, the differential diagnosis of this variant was difficult and included non-Hodgkin's lymphoma (peripheral T-cell lymphoma), Ki-1-positive lymphoma, medullary carcinoma, metastatic carcinoma, melanoma, and granulocytic sarcoma. Immunologic analysis by immunoperoxidase technique showed a phenotype consistent with "syncytial variant" Hodgkin's disease: Leu-M1+, Ki-1+, IL-2+, HLA-DR+, T11-, pan B-, K-, lambda-, cytokeratin-, S-100-, muramidase-.
我们遇到了一例“肉瘤样”或“合体细胞变异型”复发性霍奇金病，该病例发生于经典结节硬化型霍奇金病经淋巴结治疗后，从纵隔扩展至先前未受累的结外部位（乳房）和心包。这种组织学变异型由大片大的、未分化的肿瘤细胞组成，几乎没有结节硬化型霍奇金病的诊断特征。因此，该变异型的鉴别诊断很困难，包括非霍奇金淋巴瘤（外周T细胞淋巴瘤）、Ki-1阳性淋巴瘤、髓样癌、转移性癌、黑色素瘤和粒细胞肉瘤。通过免疫过氧化物酶技术进行的免疫分析显示其表型与“合体细胞变异型”霍奇金病一致：Leu-M1+、Ki-1+、IL-2+、HLA-DR+、T11-、全B-、K-、λ-、细胞角蛋白-、S-100-、溶菌酶-。
