Koduru P R, Susin M, Kolitz J E, Soni M, Teichberg S, Siques M J, Sun T, Amorosi E, Budman D R
Department of Laboratories, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.
Am J Hematol. 1995 Mar;48(3):192-200. doi: 10.1002/ajh.2830480310.
Sinus histiocytosis with massive lymphadenopathy (SHML) is a rare benign disease of unknown etiology. It is rarely associated with malignant lymphoma. This report documents the first case of a T-cell lymphoma, which developed in a patient with a 10-year history of SHML. The disease was complicated by hypereosinophilia and massive retroperitoneal lymphadenopathy. Histological examination of a cervical lymph node biopsy during the terminal phase identified a lymphoma composed of cells with morphological plasmacytoid features. Ultrastructurally, the tumor cells showed poorly developed cytoplasm, nuclei with peripheral chromatin clumping, and inconspicuous nucleoli. Cytogenetic studies showed two related clones. On immunohistochemical staining tumor cells were positive with monoclonal antibodies (mAb) CD3 and CD45RO. Southern blotting analysis identified clonal rearrangements in the T-cell receptor (TCR) alpha, beta and gamma genes. Thus, T-cell lineage of the tumor cells was established. In situ hybridization of interleukin-2 (IL-2) and interleukin-5 (IL-5) cDNA probes on tissue sections identified the synthesis of IL-5 by the eosinophils, suggesting an autocrine pathway of eosinophilopoiesis leading to hypereosinophilia in this patient.
伴有巨大淋巴结病的窦组织细胞增生症（SHML）是一种病因不明的罕见良性疾病。它很少与恶性淋巴瘤相关。本报告记录了首例发生在有10年SHML病史患者身上的T细胞淋巴瘤病例。该疾病并发嗜酸性粒细胞增多和巨大的腹膜后淋巴结病。终末期颈部淋巴结活检的组织学检查发现一种由具有形态学浆细胞样特征的细胞组成的淋巴瘤。超微结构上，肿瘤细胞显示细胞质发育不良，细胞核周边染色质聚集，核仁不明显。细胞遗传学研究显示两个相关克隆。免疫组化染色显示肿瘤细胞对单克隆抗体（mAb）CD3和CD45RO呈阳性。Southern印迹分析确定了T细胞受体（TCR）α、β和γ基因的克隆重排。因此，确定了肿瘤细胞的T细胞谱系。在组织切片上对白介素-2（IL-2）和白介素-5（IL-5）cDNA探针进行原位杂交，确定嗜酸性粒细胞合成IL-5，提示嗜酸性粒细胞生成的自分泌途径导致该患者嗜酸性粒细胞增多。
