Schmid U, Cogliatti S B, Diss T C, Isaacson P G
Department of Pathology, Kantonsspital, St Gallen, Switzerland.
Histopathology. 1996 Sep;29(3):201-8. doi: 10.1111/j.1365-2559.1996.tb01392.x.
We report on two cases of low grade follicle centre cell lymphoma with a pronounced parafollicular monocytoid/ marginal zone B-cell component. One patient had a history of preceeding follicular high grade B-cell lymphoma of centroblastic type showing the same light chain restriction and identical immunoglobulin heavy chain gene rearrangement as the low grade lymphoma diagnosed 15 months later. Morphologically, in both cases the two constituents of the low grade tumours were clearly distinguishable. Immunohistochemically, the follicular component strongly expressed bcl-2 protein in contrast to a weak staining of the marginal zone B-cell component. Performing PCR, a rearrangement of the major breakpoint region of bcl-2 was not found. Identical light chain restriction of the follicular and the monocytoid B-cell/marginal zone components strongly indicates a clonal relationship between them. A monocytoid/marginal zone B-cell component in follicular lymphoma probably results from differentiation of the follicle centre cells and does not indicate a composite lymphoma.
我们报告了两例伴有明显滤泡旁单核细胞样/边缘区B细胞成分的低级别滤泡中心细胞淋巴瘤。一名患者曾有过中心母细胞型滤泡高级别B细胞淋巴瘤病史，其轻链限制与15个月后诊断出的低级别淋巴瘤相同，免疫球蛋白重链基因重排也相同。形态学上，在这两例中，低级别肿瘤的两种成分均可清晰区分。免疫组织化学显示，滤泡成分强烈表达bcl-2蛋白，而边缘区B细胞成分染色较弱。进行PCR检测未发现bcl-2主要断裂点区域重排。滤泡和单核细胞样B细胞/边缘区成分的轻链限制相同，强烈提示它们之间存在克隆关系。滤泡淋巴瘤中的单核细胞样/边缘区B细胞成分可能源于滤泡中心细胞的分化，并不提示为复合淋巴瘤。
