de Bruin P C, Kummer J A, van der Valk P, van Heerde P, Kluin P M, Willemze R, Ossenkoppele G J, Radaszkiewicz T, Meijer C J
Department of Pathology, Free University Hospital, Amsterdam, The Netherlands.
Blood. 1994 Dec 1;84(11):3785-91.
T-cell non-Hodgkin's lymphomas can be considered the neoplastic equivalents of immunologically functional, site-restricted T lymphocytes. Little is known about the occurrence and clinical behavior of T-cell lymphomas that are the neoplastic equivalents of different functional T-cell subsets. Here, we investigated the prevalence, preferential site, immunophenotype, and clinical behavior of the neoplastic equivalents of activated cytotoxic T cells (CTLs) in a group of 140 nodal and extranodal T-cell lymphomas. Activated CTLs were shown immunohistochemically with a monoclonal antibody against granzyme B, a major constituent of the cytotoxic granules of activated T cells. Granzyme B-positive T-cell lymphomas were mainly found in mucosa-associated lymphoid tissue (MALT; nose, 63% of the cases; gastrointestinal tract, 46%; and lung, 33%). Granzyme B-positive cases with primary localization in MALT were more often associated with angioinvasion (P = .005), necrosis (P = .002), and histologic characteristics of celiac disease in adjacent mucosa not involved with lymphoma. Eosinophilia was more often observed in granzyme B-negative cases (P = .03). Most cases belonged to the pleomorphic medium- and large-cell group of the Kiel classification. CD30 expression was more often found in granzyme B-positive lymphomas of MALT (P = .04), whereas CD56 expression was exclusively found in nasal granzyme B-positive lymphomas. Immunophenotypically, most of the cases should be considered as neoplastic equivalents of activated CTLs based on the presence of T-cell markers on tumor cells. In two cases of nasal lymphoma, tumor cells probably were the neoplastic counterparts of natural killer cells. The prognosis of the granzyme B-positive gastrointestinal T-cell lymphomas was poor but did not differ from granzyme B-negative gastrointestinal T-cell lymphomas. This indicates that, in peripheral T-cell lymphomas, site of origin is more important as a prognostic parameter than derivation of activated CTLs.
T细胞非霍奇金淋巴瘤可被视为具有免疫功能、部位受限的T淋巴细胞的肿瘤等同物。对于不同功能T细胞亚群的肿瘤等同物即T细胞淋巴瘤的发生及临床行为，人们了解甚少。在此，我们在一组140例淋巴结及结外T细胞淋巴瘤中，研究了活化细胞毒性T细胞（CTL）的肿瘤等同物的患病率、偏好部位、免疫表型及临床行为。通过使用针对颗粒酶B（活化T细胞细胞毒性颗粒的主要成分）的单克隆抗体进行免疫组织化学检测，显示活化的CTL。颗粒酶B阳性T细胞淋巴瘤主要见于黏膜相关淋巴组织（MALT；鼻部，63%的病例；胃肠道，46%；肺部，33%）。原发于MALT的颗粒酶B阳性病例更常伴有血管侵犯（P = 0.005）、坏死（P = 0.002）以及未受淋巴瘤累及的相邻黏膜中乳糜泻的组织学特征。嗜酸性粒细胞增多更常见于颗粒酶B阴性病例（P = 0.03）。大多数病例属于 Kiel 分类中的多形性中、大细胞组。CD30表达更常见于MALT的颗粒酶B阳性淋巴瘤（P = 0.04），而CD56表达仅见于鼻部颗粒酶B阳性淋巴瘤。免疫表型上，基于肿瘤细胞上T细胞标志物的存在，大多数病例应被视为活化CTL的肿瘤等同物。在两例鼻淋巴瘤病例中，肿瘤细胞可能是自然杀伤细胞的肿瘤对应物。颗粒酶B阳性胃肠道T细胞淋巴瘤的预后较差，但与颗粒酶B阴性胃肠道T细胞淋巴瘤并无差异。这表明，在外周T细胞淋巴瘤中，作为预后参数，起源部位比活化CTL的来源更为重要。
