Delecluse H J, Anagnostopoulos I, Dallenbach F, Hummel M, Marafioti T, Schneider U, Huhn D, Schmidt-Westhausen A, Reichart P A, Gross U, Stein H
Institute of Pathology, Klinikum Benjamin Franklin, Free University of Berlin, Germany.
Blood. 1997 Feb 15;89(4):1413-20.
We report here a series of 16 highly malignant diffuse large B-cell lymphomas of the oral cavity with unique immunohistologic features. Fifteen of these developed in human immunodeficiency virus-positive patients. All cases displayed morphologic features of diffuse large-cell lymphomas but strikingly differed from them in that they showed a minimal or absent expression of the leukocyte common antigen as well as of the B-cell antigen CD20. Instead, the tumor cells showed a constant reaction with the plasma cell characteristic antibody VS38c and a frequent reaction with the CD79a antibody. This, in conjunction with a variable expression of cytoplasmic Ig and a monoclonal rearrangement of the Ig heavy chain gene in all of the three tested cases confirmed the B-cell nature, the clonal origin, and the plasmacellular differentiation of these neoplasms. The majority of these tumors were negative for the BCL-6 protein, with the remaining cases showing only a partial and weak expression of this antigen. An association with the Epstein-Barr virus (EBV) was found in 9 of 15 tested cases showing abundant EBV-encoded nuclear RNA transcripts in the absence of EBNA-2. Five of the EBV-positive cases variably expressed LMP-1. We propose to name these tumors plasmablastic lymphomas, in accordance with their morphologic and immunohistologic features. Knowledge of this lymphoma entity is important to avoid confusion with nonlymphoid malignancies due to the lack of commonly used lymphoid markers.
我们在此报告一系列16例具有独特免疫组织学特征的口腔高度恶性弥漫性大B细胞淋巴瘤。其中15例发生于人类免疫缺陷病毒阳性患者。所有病例均表现出弥漫性大细胞淋巴瘤的形态学特征，但与之显著不同的是，它们显示白细胞共同抗原以及B细胞抗原CD20的表达极少或缺失。相反，肿瘤细胞与浆细胞特征性抗体VS38c呈持续反应，与CD79a抗体呈频繁反应。这与所有3例检测病例中细胞质Ig的可变表达以及Ig重链基因的单克隆重排相结合，证实了这些肿瘤的B细胞性质、克隆起源和浆细胞分化。这些肿瘤大多数BCL-6蛋白呈阴性，其余病例仅显示该抗原的部分弱阳性表达。在15例检测病例中的9例发现与爱泼斯坦-巴尔病毒（EBV）有关，在缺乏EBNA-2的情况下显示大量EBV编码的核RNA转录本。5例EBV阳性病例可变表达LMP-1。根据其形态学和免疫组织学特征，我们建议将这些肿瘤命名为浆母细胞性淋巴瘤。了解这种淋巴瘤实体对于避免因缺乏常用的淋巴样标志物而与非淋巴样恶性肿瘤混淆很重要。
