Nonomura A, Ohta G
Acta Pathol Jpn. 1986 Nov;36(11):1617-26. doi: 10.1111/j.1440-1827.1986.tb02226.x.
Eighty five cases of malignant lymphoma were surveyed for the presence of angioinfiltrative and angiodestructive growth pattern of lymphoid cells with areas of necrosis and granulomatous appearance simulating lymphomatoid granulomatosis (LYG). LYG-like changes were observed in 13 of 85 cases (15%). The most frequent histology was diffuse large cell lymphoma which occurred in 8 cases (4 non-cleaved, 3 cleaved, and one immunoblastic), followed by three diffuse pleomorphic lymphoma, one diffuse medium-sized lymphoma, and one Hodgkin's disease of mixed cellularity. The most frequent involving site was the lung, as well as the soft tissue. Composition of lymphoid infiltrate varied markedly from case to case and from area to area in the same case. One was solely composed of monotonous atypical cells, other pleomorphic cells including benign lymphocytes, plasma cells, leukocytes, and histiocytes with a varied number of atypical reticuloendothelial cells. The latter histologic appearance was just similar to LYG. Veins were more frequently affected than arteries. The present study indicates that, although the angioinfiltrative and angiodestructive growth pattern of atypical lymphoreticular cells with granulomatous appearance is considered necessary for the diagnosis of LYG, it often occurs in malignant lymphoma. Therefore, one should consider the possibility of malignant lymphoma before making the diagnosis of LYG, especially in the specimens taken from the lung and soft tissue.
对85例恶性淋巴瘤进行了调查，以观察淋巴样细胞的血管浸润性和血管破坏性生长模式，其伴有坏死区域以及类似淋巴瘤样肉芽肿病（LYG）的肉芽肿外观。85例中有13例（15%）观察到类似LYG的改变。最常见的组织学类型是弥漫性大细胞淋巴瘤，共8例（4例非裂细胞型、3例裂细胞型和1例免疫母细胞型），其次是3例弥漫性多形性淋巴瘤、1例弥漫性中等大小淋巴瘤和1例混合细胞型霍奇金病。最常累及的部位是肺以及软组织。不同病例之间以及同一病例的不同区域之间，淋巴样浸润的组成差异显著。1例仅由单一的非典型细胞组成，其他则为多形性细胞，包括良性淋巴细胞、浆细胞、白细胞和组织细胞，伴有数量不等的非典型网状内皮细胞。后者的组织学表现与LYG相似。静脉比动脉更常受累。本研究表明，尽管具有肉芽肿外观的非典型淋巴网状细胞的血管浸润性和血管破坏性生长模式被认为是诊断LYG所必需的，但它也常出现在恶性淋巴瘤中。因此，在诊断LYG之前应考虑恶性淋巴瘤的可能性，尤其是在取自肺和软组织的标本中。
