Aozasa K, Ohsawa M, Horiuchi K, Mishima K, Kawano K, Ito N
Department of Pathology, Osaka University School of Medicine, Suita, Japan.
Mod Pathol. 1993 Nov;6(6):717-20.
Occurrence of monocytoid B-lymphocytes (MBL) in spleens of 34 patients with gastric cancer was examined. Histologic findings of gastric cancer including classification, depth of invasion, and stage of disease were defined based on the General Rules for the Gastric Cancer Study (Japan). MBL were defined morphologically as having abundant pale cytoplasm with distinct cell borders and small nucleus often with reniform shape. Immunohistochemically, these cells were B-cell in nature, i.e., CD15-, CD43-, CD45RA+, CD45Ro-, CD68-, CD74+, CDw75+, Mx-PanB(L26)+, MBI+, EMA-, PG-MI-. Clusters of MBL were found in 14 of 34 (41%) patients: they were found to be directly adjoining to the periarterial sheath or apart from the white pulp. In the cases without MBL, zonation of mantle zone and marginal zone was apparent with distinct secondary follicles in 72% of cases. Meanwhile, in spleens with MBL, the mantle zone showed atrophy in a half of cases, resulting in indistinct zonation of the mantle zone and marginal zone. Secondary follicles were distinct in less than 30% of cases. Correlation of the occurrence of MBL, evaluated by Spearman's correlation coefficient, revealed that the age was the most important factor (R = -0.4852, P = 0.00364): the median age of patients with and without MBL was 75.7 and 61.7 yr, respectively. The MBL were increased in gastric cancer as compared with other cancers (P < 0.03) and with noncancer spleens (P < 0.1). The age of gastric cancer patients with MBL was older than those in other cancers and noncancer patients. Therefore occurrence of MBL in spleen might be a function of aging.
对34例胃癌患者脾脏中单核样B淋巴细胞（MBL）的出现情况进行了检查。根据《胃癌研究总则》（日本）确定了胃癌的组织学表现，包括分类、浸润深度和疾病分期。MBL在形态学上被定义为具有丰富的淡染细胞质、明显的细胞边界以及通常呈肾形的小细胞核。免疫组织化学显示，这些细胞本质上是B细胞，即CD15-、CD43-、CD45RA+、CD45Ro-、CD68-、CD74+、CDw75+、Mx-PanB（L26）+、MBI+、EMA-、PG-MI-。在34例患者中有14例（41%）发现了MBL聚集：它们被发现直接毗邻动脉周围鞘或远离白髓。在没有MBL的病例中，72%的病例中套区和边缘区的分区明显，有明显的次级滤泡。同时，在有MBL的脾脏中，一半的病例套区出现萎缩，导致套区和边缘区的分区不明显。不到30%的病例中有明显的次级滤泡。通过Spearman相关系数评估MBL出现情况的相关性，结果显示年龄是最重要的因素（R = -0.4852，P = 0.00364）：有和没有MBL的患者的中位年龄分别为75.7岁和61.7岁。与其他癌症相比（P < 0.03）以及与非癌脾脏相比（P < 0.1），胃癌中MBL增多。有MBL的胃癌患者的年龄比其他癌症患者和非癌患者的年龄大。因此，脾脏中MBL的出现可能是衰老的一种表现。
