Halie M R, Eibergen R, Nieweg H O
Br Med J. 1972 Jun 10;2(5814):609-11. doi: 10.1136/bmj.2.5814.609.
The occurrence of abnormal cells in the peripheral blood of patients with Hodgkin's disease has been described in the literature. In the present investigation several varieties of cells were found, two of which are believed to be typical of the disease. The significance of these cells in the peripheral blood is not yet clear, but there seems to be a correlation between the presence of these characteristic cells in the blood and involvement of the spleen by the disease as determined by microscopical examination. In 11 patients both abnormalities proved to be absent; 13 out of 14 other patients showed both the abnormal cells in the blood and Hodgkin lesions in the spleen.If circulating abnormal cells are indeed an indication of the presence of Hodgkin's disease in the spleen, involvement of this organ is likely to be due to or to give rise to haematogenous dissemination. The other possibility remains that both the occurrence of abnormal cells in the peripheral blood and splenic involvement are due to a multicentric origin of the disease. It seems most unlikely that the splenic lesions are consistent with localized disease still restricted to the lymphoid system. These findings challenge the validity of the present widely used so-called Rye classification of clinical stages in Hodgkin's disease.
霍奇金病患者外周血中异常细胞的出现已在文献中有所描述。在本研究中发现了几种细胞类型，其中两种被认为是该疾病的典型细胞。这些细胞在外周血中的意义尚不清楚，但血液中这些特征性细胞的存在与通过显微镜检查确定的疾病累及脾脏之间似乎存在相关性。在11名患者中，两种异常情况均未出现；在其他14名患者中，有13名患者血液中出现了异常细胞，脾脏中也有霍奇金病变。如果循环中的异常细胞确实表明脾脏存在霍奇金病，那么该器官的累及可能是由于血行播散或导致血行播散。另一种可能性是外周血中异常细胞的出现和脾脏累及均归因于该疾病的多中心起源。脾脏病变似乎极不可能与仍局限于淋巴系统的局限性疾病相符。这些发现对目前广泛使用的霍奇金病临床分期的所谓赖氏分类法的有效性提出了质疑。
