Zarate-Osorno A, Medeiros L J, Kingma D W, Longo D L, Jaffe E S
Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, Maryland 20892.
Am J Surg Pathol. 1993 Feb;17(2):123-32.
We describe nine patients who initially developed non-Hodgkin's lymphoma and subsequently developed Hodgkin's disease. The median interval from the diagnosis of non-Hodgkin's lymphoma (NHL) to the diagnosis of Hodgkin's disease (HD) was 5 years (range, 2-12 years). The median age of the patients at time of diagnosis of NHL was 54 years (range, 27-81 years). Seven of nine cases (78%) of NHL were primarily nodal. According to the Working Formulation, seven NHL were follicular (two small cleaved cell, three mixed small and large cell, two large cell), one was diffuse large cell, and one was large cell immunoblastic. All NHL had histologic or immunophenotypic findings indicative of B-cell lineage. Seven of the nine patients were treated in a nonuniform manner: four with chemotherapy and three with chemotherapy and radiation therapy. At the time of HD, the median age of the patients was 59 years (range, 35-85 years). Lymph nodes were involved in all patients. Six HD biopsies were subclassified as nodular sclerosis, one as mixed cellularity, and two cases were not further subclassified. Immunophenotypic studies revealed that the Reed-Sternberg and Hodgkin cells were LeuM1 or BerH2 positive and LCA negative in eight of nine biopsies, supporting the histologic diagnosis. These results further demonstrate that patients with NHL may subsequently develop HD. The NHLs are usually of B-cell lineage. The results also emphasize the need for rebiopsy in patients with NHL who experience an apparent clinical relapse.
我们描述了9例最初患非霍奇金淋巴瘤，随后又患霍奇金病的患者。从非霍奇金淋巴瘤（NHL）诊断到霍奇金病（HD）诊断的中位间隔时间为5年（范围2 - 12年）。患者诊断NHL时的中位年龄为54岁（范围27 - 81岁）。9例NHL中有7例（78%）主要累及淋巴结。根据工作分类法，7例NHL为滤泡性（2例小裂细胞型、3例混合小和大细胞型、2例大细胞型），1例为弥漫大细胞型，1例为大细胞免疫母细胞型。所有NHL均有组织学或免疫表型结果提示B细胞系。9例患者中有7例接受了不统一的治疗：4例接受化疗，3例接受化疗和放疗。HD诊断时，患者的中位年龄为59岁（范围35 - 85岁）。所有患者均有淋巴结受累。6例HD活检标本被分类为结节硬化型，1例为混合细胞型，2例未进一步分类。免疫表型研究显示，9例活检标本中有8例的里德 - 斯腾伯格细胞和霍奇金细胞LeuM1或BerH2阳性而LCA阴性，支持组织学诊断。这些结果进一步证明NHL患者可能随后发生HD。NHL通常为B细胞系。结果还强调了对明显临床复发的NHL患者进行再次活检的必要性。
