Kumamoto M, Nakamine H, Hara T, Yokoya Y, Kawai J, Ito H, Nishioka S, Takenaka T, Wickert R S, Mitchell D W
Second Department of Internal Medicine, Wakayama Medical University, Japan.
Cancer. 1994 Dec 1;74(11):3023-8. doi: 10.1002/1097-0142(19941201)74:11<3023::aid-cncr2820741120>3.0.co;2-y.
Spontaneous regression of non-Hodgkin's lymphoma, occasionally reported in low grade groups, is a rare phenomenon in high grade groups. Clonal proliferation has not been confirmed in the majority of reported cases. In this woman, age 58 years, who had been diagnosed as having high grade immunoblastic lymphoma after excision of a single cervical lymph node, the remaining bilateral cervical, inguinal, and axillary adenopathy regressed completely without any cytotoxic treatments 22 days after biopsy. At the time of this writing, the patient has been free of disease for 24 months.
Clonality of the lymphoproliferation in the case was examined by immunohistochemistry and polymerase chain reaction (PCR) amplification using paraffin embedded biopsy material. Possible implications of Epstein-Barr virus in the pathogenesis of this process was examined also by PCR amplification and in situ hybridization.
The proliferating lymphoid cells showed restricted expression of immunoglobulin (Ig) light chain and amplification of clonally rearranged V-D-J regions of Ig heavy chain gene. Epstein-Barr virus did not appear to be involved in the process.
The present study shows that spontaneous complete regression of clonal lymphoproliferation that is morphologically a high grade lymphoma can occur.
非霍奇金淋巴瘤的自发消退在低级别组中偶尔有报道，但在高级别组中是一种罕见现象。在大多数报道的病例中，克隆性增殖尚未得到证实。在这位58岁的女性患者中，其在切除单个颈部淋巴结后被诊断为高级别免疫母细胞淋巴瘤，活检后22天，其余双侧颈部、腹股沟和腋窝淋巴结病在未进行任何细胞毒性治疗的情况下完全消退。在撰写本文时，该患者已无病生存24个月。
使用石蜡包埋的活检材料，通过免疫组织化学和聚合酶链反应（PCR）扩增检测该病例中淋巴细胞增殖的克隆性。还通过PCR扩增和原位杂交检测了爱泼斯坦-巴尔病毒在这一过程发病机制中的可能作用。
增殖的淋巴细胞显示免疫球蛋白（Ig）轻链表达受限，Ig重链基因的克隆性重排V-D-J区域扩增。爱泼斯坦-巴尔病毒似乎未参与此过程。
本研究表明，形态学上为高级别淋巴瘤的克隆性淋巴细胞增殖可发生自发完全消退。
