Nakamura S, Sasajima Y, Koshikawa T, Kitoh K, Koike K, Motoori T, Ueda R, Mori S, Suchi T
Department of Pathology and Clinical Laboratories, Aichi Cancer Center Hospital, Nagoya, Japan.
Pathol Int. 1995 Dec;45(12):958-64. doi: 10.1111/j.1440-1827.1995.tb03422.x.
A patient is described with angioimmunoblastic T-cell lymphoma (AIL) (angioimmunoblastic lymphadenopathy with dysproteinemia [AILD]-type T-cell lymphoma), which was later followed by Hodgkin's disease. At the time of the initial diagnosis, histological examination of a cervical lymph node showed a typical picture of AIL with abundant clear cells which were CD45RO+, CD43+, and CD20-, and there was no evidence of a monoclonal B-cell proliferation by immunohistochemical analysis. In situ hybridization for Epstein-Barr virus (EBV) was negative. Interposed by a bout of recurrence, the patient developed, 16 years later, a left subparotid mass which showed histologic features of Hodgkin's disease, mixed cellularity type. Diagnostic Reed-Sternberg cells and their variants were CD30+, CD15- and CD20+. Neither rearrangement of TCR beta and gamma chain genes nor of immunoglobulin heavy chain and kappa light chain genes was detected in DNA extract from fresh material. In situ hybridization showed the presence of EBV within the Reed-Sternberg cells. The data show that EBV was not etiologically related to AIL in this case. Further, the deficit in cellular immunity that accompanied AIL conceivably permit primary EBV infection or reactivation of latent infection, which eventuated in development of Hodgkin's disease, but the exact pathogenesis remains uncertain.
本文描述了一名患有血管免疫母细胞性T细胞淋巴瘤（AIL）（伴蛋白异常血症的血管免疫母细胞性淋巴结病[AILD]型T细胞淋巴瘤）的患者，该患者随后发展为霍奇金病。初次诊断时，颈部淋巴结的组织学检查显示AIL的典型表现，有大量CD45RO+、CD43+和CD20-的透明细胞，免疫组化分析未发现单克隆B细胞增殖的证据。爱泼斯坦-巴尔病毒（EBV）原位杂交为阴性。在一次复发之后，16年后患者出现左腮腺下肿物，其组织学特征为霍奇金病混合细胞型。诊断性里德-斯腾伯格细胞及其变异型CD30+、CD15-和CD20+。在新鲜材料的DNA提取物中未检测到TCRβ和γ链基因以及免疫球蛋白重链和κ轻链基因的重排。原位杂交显示里德-斯腾伯格细胞内存在EBV。数据表明，在该病例中EBV与AIL无病因学关联。此外，AIL伴随的细胞免疫缺陷可能使原发性EBV感染或潜伏感染再激活，最终导致霍奇金病的发生，但确切的发病机制仍不确定。
