Shin S S, Ben-Ezra J, Burke J S, Sheibani K, Rappaport H
Department of Pathology, City of Hope National Medical Center, Duarte, CA 91010.
Am J Clin Pathol. 1993 Jun;99(6):658-62. doi: 10.1093/ajcp/99.6.658.
Multinucleated giant cells resembling Reed-Sternberg (RS) cells are occasionally observed in high-grade lymphomas of the large-cell or immunoblastic type, but much less commonly in low-grade lymphomas. This study was conducted to determine whether RS-like cells found in seven B-cell low-grade lymphomas were immunologically similar to the neoplastic cells in the lymphoma or to the true RS cells seen in Hodgkin's disease, and whether they were therefore indicative of a composite lymphoma. Immunohistochemical studies were performed on paraffin sections of the seven low-grade (one small lymphocytic, one mantle zone, and five follicular) lymphomas with a panel of antibodies reactive with leukocyte common antigen (LCA), B-cell, T-cell, and Hodgkin's disease associated antigens. The RS-like cells were reactive with LCA (four of six), L26 (seven of seven), LN1 (five of six), LN2 (two of six), and MB2 (three of six). No positive staining was seen with either Leu-M1 or Ber-H2. The RS-like cells in the mantle zone lymphoma expressed L26, Leu-22, and kappa cytoplasmic light chains. This immunophenotype is similar to that of the neoplastic small lymphocytic cells. One of the low-grade follicular lymphomas progressed to an immunoblastic lymphoma with many RS-like cells. Paraffin immunohistochemistry on both lesions revealed a similar B-cell phenotype for the RS-like cells. Immunogenetic studies revealed B-cell and bcl-2 gene rearrangements in the immunoblastic lymphoma. These results indicate that RS-like cells in low-grade lymphomas are transformed neoplastic cells of B-cell lineage. With careful morphologic examination augmented by immunohistochemical studies, these lesions can be differentiated from Hodgkin's disease and from composite lymphomas of the combined Hodgkin's and non-Hodgkin's type.
在大细胞或免疫母细胞型高级别淋巴瘤中偶尔会观察到类似里德-施特恩伯格（RS）细胞的多核巨细胞，但在低级别淋巴瘤中则较少见。本研究旨在确定在7例B细胞低级别淋巴瘤中发现的RS样细胞在免疫方面是否与淋巴瘤中的肿瘤细胞或霍奇金病中所见的真正RS细胞相似，以及它们是否因此提示为复合性淋巴瘤。对这7例低级别（1例小淋巴细胞性、1例套细胞区和5例滤泡性）淋巴瘤的石蜡切片进行了免疫组织化学研究，使用了一组与白细胞共同抗原（LCA）、B细胞、T细胞和霍奇金病相关抗原反应的抗体。RS样细胞与LCA（6例中的4例）、L26（7例中的7例）、LN1（6例中的5例）、LN2（6例中的2例）和MB2（6例中的3例）反应。Leu-M1或Ber-H2均未见阳性染色。套细胞区淋巴瘤中的RS样细胞表达L26、Leu-22和κ细胞质轻链。这种免疫表型与肿瘤性小淋巴细胞细胞的免疫表型相似。1例低级别滤泡性淋巴瘤进展为具有许多RS样细胞的免疫母细胞淋巴瘤。对这两种病变进行的石蜡免疫组织化学显示，RS样细胞具有相似的B细胞表型。免疫遗传学研究显示免疫母细胞淋巴瘤中有B细胞和bcl-2基因重排。这些结果表明，低级别淋巴瘤中的RS样细胞是B细胞系的转化肿瘤细胞。通过仔细的形态学检查并辅以免疫组织化学研究，这些病变可与霍奇金病以及霍奇金和非霍奇金混合型复合性淋巴瘤相鉴别。
