Thabaut A, Cristau P, Saliou P, Durosoir J L, Larroque D, Roue R, Combemale P, Duriez R
Ann Med Interne (Paris). 1979;130(11):541-5.
A patient aged 65 years was observed to have successive adenomegalic syndromes over a period of 4 years, with variable histological appearances. A right cervical adenopathy had the histological appearance of a simple antigenic-stimulation lesion. Three years later, a right inguinal adenomegaly presented all the histological criteria of angioimmunoblastic adenopathies, without, however, any humoral immunity disturbance. Two months later, a biopsy of a palatine tumour confirmed the diagnosis of an immunoblastic sarcoma. The condition then became generalized as a lymphoblastic type of diffuse lymphosarcoma, and autopsy one year later showed the presence of a pleomorphic lymphosarcoma in several lymphoid formations. This case serves as a basis for discussing the concept of angio-immunoblastic adenopathy; the result of various antigenic aggressions or the early stage of a haematosarcoma. It also clearly demonstrates the sometimes contingent characteristics and difficulties in classification of haematosarcomas.
一名65岁患者在4年期间出现了连续的腺病综合征,组织学表现各异。右侧颈部淋巴结病具有单纯抗原刺激病变的组织学表现。三年后,右侧腹股沟淋巴结肿大呈现血管免疫母细胞性淋巴结病的所有组织学标准,但无任何体液免疫紊乱。两个月后,腭部肿瘤活检确诊为免疫母细胞肉瘤。病情随后发展为弥漫性淋巴细胞型淋巴瘤并全身播散,一年后的尸检显示多个淋巴组织存在多形性淋巴瘤。该病例为讨论血管免疫母细胞性淋巴结病的概念提供了依据,血管免疫母细胞性淋巴结病是各种抗原侵袭的结果还是血液肉瘤的早期阶段。它还清楚地表明了血液肉瘤在分类时有时具有的偶然特征和困难。