Foucar K, Armitage J O, Dick F R
Cancer. 1983 Jun 1;51(11):2090-9. doi: 10.1002/1097-0142(19830601)51:11<2090::aid-cncr2820511123>3.0.co;2-g.
The clinical and pathologic features of 47 cases of malignant lymphoma, diffuse mixed small and large cell (diffuse mixed lymphoma) are described. Diffuse mixed lymphomas contained approximately equal numbers of small and large cells (30-70%) and comprised 6% of all non-Hodgkin's lymphomas. They occurred in middle-aged and elderly patients (median age = 63 years), showed a female predominance, and were clinically advanced at presentation. The majority of patients exhibited prominent extranodal disease, which frequently involved multiple unrelated sites and usually occurred in conjunction with nodal disease. A notable morphologic spectrum of lymphoma was seen within this series, including 20 cases of mixed small cleaved and large cell (with cleaved and noncleaved nuclei), eight cases of mixed small lymphocytic and large cell (transformed prolymphocytes and blast-like cells), and 12 cases of mixed small cell and large cell, "immunoblastic" lymphoma (with plasmacytoid, clear cell or hyperconvoluted features). There was no significant difference in response to treatment and survival between those cases with less than 50% large cells and those with greater than 50% large cells. The poorest treatment response appeared to be in patients with mixed small cell and large cell, "immunoblastic" lymphomas. Patients with diffuse mixed lymphoma appeared to show a favorable response to cyclphosphamide, Adriamycin, vincristine, and prednisone (CHOP) and an unfavorable response to other treatment modalities.
本文描述了47例恶性淋巴瘤——弥漫性混合小细胞和大细胞淋巴瘤（弥漫性混合淋巴瘤）的临床和病理特征。弥漫性混合淋巴瘤中小细胞和大细胞数量大致相等（30%-70%），占所有非霍奇金淋巴瘤的6%。它们发生于中年和老年患者（中位年龄=63岁），女性居多，就诊时临床分期较晚。大多数患者有明显的结外病变，常累及多个不相关部位，且通常与结内病变同时出现。在这一系列病例中可见到显著的淋巴瘤形态谱，包括20例混合小裂细胞和大细胞淋巴瘤（核有裂和无裂）、8例混合小淋巴细胞和大细胞淋巴瘤（转化型原淋巴细胞和母细胞样细胞）以及12例混合小细胞和大细胞“免疫母细胞性”淋巴瘤（有浆细胞样、透明细胞或高度卷曲特征）。大细胞少于50%的病例与大细胞多于50%的病例在治疗反应和生存率方面无显著差异。治疗反应最差的似乎是混合小细胞和大细胞“免疫母细胞性”淋巴瘤患者。弥漫性混合淋巴瘤患者似乎对环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP方案）反应良好，而对其他治疗方式反应不佳。
