Khan S M, Cottrell B J, Millward-Sadler G H, Wright D H
Department of Histopathology, Southampton General Hospital, Portsmouth, UK.
Histopathology. 1993 Sep;23(3):217-24. doi: 10.1111/j.1365-2559.1993.tb01193.x.
We describe a series of eight cases of T-cell-rich B-cell lymphoma diagnosed on liver biopsy and collected over a period of 15 years. Of seven cases that were referred from elsewhere, in only one was the correct diagnosis of B-cell lymphoma suggested. Common errors included misdiagnosis as inflammatory disease on histology, and misinterpretation as T-cell lymphoma on immunohistochemistry. However, the cases had a distinct morphological appearance and immunohistochemical profile. They showed a lymphohistiocytic or granulomatous infiltrate, usually centred on portal tracts and containing abundant small T-cells and scanty B-cell blasts. All patients had an atypical clinical presentation which favoured non-neoplastic liver disease. In seven cases liver involvement represented Stage IV disease and in one case disease was confined to the liver consistent with a primary hepatic lymphoma. Despite combination chemotherapy, the prognosis was poor with no patients surviving beyond 15 months from diagnosis. We believe T-cell-rich B-cell lymphoma to be an under-recognized subset of non-Hodgkin's lymphoma that may mimic primary liver disease.
我们描述了一系列8例经肝活检诊断的富于T细胞的B细胞淋巴瘤病例，这些病例是在15年的时间里收集到的。在从其他地方转诊来的7例病例中，只有1例被正确诊断为B细胞淋巴瘤。常见的错误包括组织学上误诊为炎症性疾病，以及免疫组织化学上误判为T细胞淋巴瘤。然而，这些病例具有独特的形态学表现和免疫组织化学特征。它们表现为淋巴组织细胞性或肉芽肿性浸润，通常以门管区为中心，含有丰富的小T细胞和少量B细胞母细胞。所有患者均有非典型的临床表现，提示为非肿瘤性肝病。7例患者肝脏受累为IV期疾病，1例患者疾病局限于肝脏，符合原发性肝淋巴瘤。尽管采用了联合化疗，但预后较差，从诊断起无患者存活超过15个月。我们认为富于T细胞的B细胞淋巴瘤是一种未被充分认识的非霍奇金淋巴瘤亚型，可能会模仿原发性肝病。
