Osborne B M, Butler J J
Am J Surg Pathol. 1984 Oct;8(10):725-33. doi: 10.1097/00000478-198410000-00001.
Fifty patients whose lymph node biopsies showed reactive follicular hyperplasia with the presence of progressive transformation of germinal centers were evaluated for current status of health, prior or subsequent development of Hodgkin's disease, and etiology of the lymph node hyperplasia. Histologically, on a background of reactive follicular hyperplasia, the nodes contained one or more germinal centers showing progressive transformation. These were three to four times the diameter of the other germinal centers and composed predominantly of small, round lymphocytes admixed with scattered immunoblasts and occasional benign histiocytes. Clinically, the majority of these patients were young males presenting with an asymptomatic solitary enlarged lymph node. fifteen had prior Hodgkin's disease. Five had concurrent progressive transformation of germinal centers and lymphocytic predominance Hodgkin's disease (two of these also had a subsequent biopsy showing only progressive transformation of germinal centers). All are currently free of Hodgkin's disease at 1-21 years. The largest group of 31 patients had no prior or subsequent Hodgkin's disease. One of the 50 developed multiple myeloma. Recognition of this phenomenon is important so that it will not be misconstrued as recurrent Hodgkin's disease, as de novo Hodgkin's disease, or as follicular lymphoma, which occurred in 12 (24%) of the cases.
对50例淋巴结活检显示反应性滤泡增生伴生发中心进行性转化的患者，评估其健康现状、霍奇金病的既往或后续发展情况以及淋巴结增生的病因。组织学上，在反应性滤泡增生的背景下，淋巴结含有一个或多个显示进行性转化的生发中心。这些生发中心的直径是其他生发中心的三到四倍，主要由小圆形淋巴细胞组成，混有散在的免疫母细胞和偶尔的良性组织细胞。临床上，这些患者大多数是年轻男性，表现为无症状的孤立性肿大淋巴结。15例有既往霍奇金病。5例同时存在生发中心进行性转化和淋巴细胞为主型霍奇金病（其中2例随后的活检仅显示生发中心进行性转化）。所有患者目前在1至21年期间均无霍奇金病。最大的一组31例患者无既往或后续霍奇金病。50例中有1例发生了多发性骨髓瘤。认识到这种现象很重要，这样它就不会被误解为复发性霍奇金病、原发性霍奇金病或滤泡性淋巴瘤，在12例（24%）病例中出现了这种情况。
