Wacker H H, Tiemann M, Menke M A, Back A, Parwaresch R M
Institut für Hämatopathologie, Universität Kiel.
Verh Dtsch Ges Pathol. 1994;78:208-13.
Malignant non-Hodgkins lymphoma with primary involvement of the thyroid is a rare disease. Nearly all these lymphomas are of B-cell phenotype, and they represent a broad morphological spectrum of high and low grade entities. We investigated 18 cases of Hashimotos disease and 95 cases of thyroid non-Hodgkins lymphoma including 16 cases of MALT-lymphoma. This type of lymphoma is often hardly distinguishable from reactive lesions, even by immunohistochemistry. Therefore, we introduced a new molecular genetic technique based on the polymerase chain reaction (PCR) combined with temperature-gradient gel electrophoresis to demonstrate monoclonal populations of B cells in a polyclonal background of reactive B lymphocytes. With this approach we found monoclonality in 4 of 18 cases of Hashimotos disease. In our opinion, these 4 cases demonstrate clearly the transition from autoimmune disease into non-Hodgkins lymphoma.
原发性累及甲状腺的恶性非霍奇金淋巴瘤是一种罕见疾病。几乎所有这些淋巴瘤均为B细胞表型，且涵盖了从高分级到低分级实体的广泛形态学谱。我们研究了18例桥本氏病患者以及95例甲状腺非霍奇金淋巴瘤患者，其中包括16例黏膜相关淋巴组织淋巴瘤。即便通过免疫组织化学方法，这类淋巴瘤往往也很难与反应性病变区分开来。因此，我们引入了一种基于聚合酶链反应（PCR）并结合温度梯度凝胶电泳的新分子遗传学技术，以在反应性B淋巴细胞的多克隆背景中显示B细胞的单克隆群体。通过这种方法，我们在18例桥本氏病患者中发现了4例存在单克隆性。我们认为，这4例清晰地显示了从自身免疫性疾病向非霍奇金淋巴瘤的转变。
