Nakagawa A, Nakamura S, Koshikawa T, Nakayama A, Nagasaka T, Motoori T, Kojima M, Hosomura Y, Ueda R, Mori S
Department of Pathology, Nagoya University School of Medicine, Japan.
Acta Pathol Jpn. 1993 Jan-Feb;43(1-2):44-54. doi: 10.1111/j.1440-1827.1993.tb02913.x.
We studied the morphologic, immunologic and clinical features of 14 cases of primary non-lymphoblastic non-Hodgkin's lymphomas of the mediastinum. The patients ranged in age from 3 to 76 years, with a median age of 28 years. According to the Ann Arbor classification, 71% of our cases were in an early stage. Three cases were in Stage I, eight in Stage II, one in Stage III and two in Stage IV (one with multiple hepatic lesions and another with bone marrow involvement). The patients were heterogeneous in terms of the disease and were therefore histologically classified into three categories: diffuse large B cell lymphoma with sclerosis (DLS; n = 8); large cell anaplastic lymphoma (LC-Ana; n = 5); and low grade B cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma; n = 1). DLS was the most common group and was characterized as CD5-, CD10-, CD19+, CD20+, CD21- and CD22+. Imprint smears showed azurophilic granules in the cytoplasm of the tumor cells of three of four DLS cases. All of the six cases examined were negative when tested for Epstein-Barr virus (EBV) sequences after hybridization with the EBV internal repeat probe. DLS and MALT lymphoma cases were of a B-lineage lymphoma of the thymus, while most of the LC-Ana cases were of a T-lineage lymphoma. Patients with non-lymphoblastic non-Hodgkin's lymphomas had a relatively favorable prognosis compared with lymphoblastic lymphoma (P < 0.01 by the generalized Wilcoxon test). There was no significant difference in the survival between non-lymphoblastic non-Hodgkin's lymphoma and Hodgkin's disease (P > 0.05 by the generalized Wilcoxon test).
我们研究了14例原发性纵隔非淋巴细胞性非霍奇金淋巴瘤的形态学、免疫学及临床特征。患者年龄范围为3至76岁，中位年龄为28岁。根据Ann Arbor分类，71%的病例处于早期阶段。3例为I期，8例为II期，1例为III期，2例为IV期（1例有多处肝脏病变，另1例有骨髓受累）。这些患者在疾病方面具有异质性，因此在组织学上分为三类：硬化性弥漫大B细胞淋巴瘤（DLS；n = 8）；大细胞间变性淋巴瘤（LC-Ana；n = 5）；黏膜相关淋巴组织低度B细胞淋巴瘤（MALT淋巴瘤；n = 1）。DLS是最常见的类型，其特征为CD5-、CD10-、CD19+、CD20+、CD21-和CD22+。印片涂片显示4例DLS病例中有3例肿瘤细胞胞质内有嗜天青颗粒。6例检测病例在用EBV内部重复探针杂交后检测EBV序列时均为阴性。DLS和MALT淋巴瘤病例为胸腺来源的B系淋巴瘤，而大多数LC-Ana病例为T系淋巴瘤。与淋巴细胞性淋巴瘤相比，非淋巴细胞性非霍奇金淋巴瘤患者的预后相对较好（广义Wilcoxon检验，P < 0.01）。非淋巴细胞性非霍奇金淋巴瘤与霍奇金病的生存率无显著差异（广义Wilcoxon检验，P > 0.05）。
