Camilleri-Broët S, Davi F, Feuillard J, Seilhean D, Michiels J F, Brousset P, Epardeau B, Navratil E, Mokhtari K, Bourgeois C, Marelle L, Raphäel M, Hauw J J
Département de Neuropathologie, INSERM U360, CNRS URA 625, CHU Pitié-Salpêtrière, Paris, France.
Hum Pathol. 1997 Mar;28(3):367-74. doi: 10.1016/s0046-8177(97)90137-4.
Fifty-one cases of acquired immunodeficiency syndrome (AIDS)-related primary brain lymphomas (AR-PBL) were investigated for clinical characteristics; human immunodeficiency virus (HIV)-associated disorders; histopathologic features; immunophenotype; Epstein-Barr virus (EBV) infection; and, when frozen tissue was available, oncogene rearrangements. AR-PBL occurred late in the course of AIDS and were usually associated with other systemic or cerebral disorders and with a low level of CD4 lymphocytes. All cases were high grade lymphomas according to the Working Formulation or updated Kiel classification, and often displayed a multifocal pattern. Thirty cases were classified as immunoblastic with plasmacytic differentiation, 18 cases were large cell lymphomas with an immunoblastic component or centroblastic polymorphic lymphomas, and 2 were small noncleaved non-Burkitt lymphomas (Working Formulation). This latter category is classified as Burkitt's-like lymphoma in the REAL nomenclature. One case could not be classified because of necrosis. AR-PBL showed a high level expression of activation and adhesion molecules. The presence of EBV was detected in most cases, and, when PCR was used, this was a constant finding. bcl-2 oncoprotein and latent membrane protein-1 (LMP-1) were strongly expressed. None of the tested cases expressed p53, or were rearranged for bcl-2 or c-myc oncogenes. This study confirms the immunophenotypic specificity of AR-PBL, which may reflect the special immune status of the brain.
对51例获得性免疫缺陷综合征（AIDS）相关原发性脑淋巴瘤（AR-PBL）进行了临床特征、人类免疫缺陷病毒（HIV）相关疾病、组织病理学特征、免疫表型、爱泼斯坦-巴尔病毒（EBV）感染的调查；并且，在有冷冻组织的情况下，还进行了癌基因重排的检测。AR-PBL发生于AIDS病程后期，通常与其他全身或脑部疾病以及低水平的CD4淋巴细胞相关。根据工作分类法或更新的基尔分类法，所有病例均为高级别淋巴瘤，且常呈多灶性模式。30例被分类为具有浆细胞分化的免疫母细胞性淋巴瘤，18例为具有免疫母细胞成分的大细胞淋巴瘤或中心母细胞多形性淋巴瘤，2例为小无裂非伯基特淋巴瘤（工作分类法）。在REAL命名法中，后一类被分类为伯基特样淋巴瘤。1例因坏死无法分类。AR-PBL显示激活分子和黏附分子的高表达。大多数病例检测到EBV的存在，当使用PCR检测时，这是一个恒定的发现。bcl-2癌蛋白和潜伏膜蛋白-1（LMP-1）强烈表达。所有检测病例均未表达p53，也未检测到bcl-2或c-myc癌基因重排。本研究证实了AR-PBL的免疫表型特异性，这可能反映了脑的特殊免疫状态。
