Labouyrie E, Marit G, Vial J P, Lacombe F, Fialon P, Bernard P, de Mascarel A, Merlio J P
Laboratoire d'Anatomie Pathologique, Hôpital Haut-Lévêque, CHU de Bordeaux, Pessac, France.
Mod Pathol. 1997 Oct;10(10):1015-20.
Splenic lymphoma with villous lymphocytes (SLVL) is a chronic monoclonal B-cell lymphoproliferative disorder characterized by massive splenomegaly and typical villous lymphocytes in the peripheral blood (PB). The diagnosis of SLVL relies on blood smear examination, phenotypic features, and marginal zone involvement of the spleen. The histologic pattern of bone marrow (BM) involvement has not been well characterized. We report four cases associated with a peculiar intrasinusoidal BM involvement. This intrasinusoidal pattern was highlighted by immunostaining that also showed the cytoplasmic projections of villous lymphocytes within routinely fixed and decalcified BM biopsy specimens. Therefore, a simple immunohistochemical analysis of BM involvement would help to identify SLVL. Combined with cytologic and immunophenotypic evaluation of marrow and blood smears, this intravascular pattern might be helpful in differentiating SLVL from hairy cell leukemia and its variant. Whether this peculiar intravascular pattern combined with cytologic evaluation represents a practical alternative to the diagnostic splenectomy must be confirmed by extensive studies focusing on this immunohistochemical criterion.
伴有绒毛淋巴细胞的脾淋巴瘤（SLVL）是一种慢性单克隆B细胞淋巴增殖性疾病，其特征为脾肿大及外周血中出现典型的绒毛淋巴细胞。SLVL的诊断依赖于血涂片检查、表型特征以及脾脏边缘区受累情况。骨髓（BM）受累的组织学模式尚未得到充分描述。我们报告了4例伴有特殊的窦内BM受累的病例。这种窦内模式通过免疫染色得以凸显，免疫染色还显示了常规固定和脱钙的BM活检标本中绒毛淋巴细胞的胞质突起。因此，对BM受累情况进行简单的免疫组化分析有助于识别SLVL。结合骨髓和血涂片的细胞学及免疫表型评估，这种血管内模式可能有助于将SLVL与毛细胞白血病及其变异型相鉴别。这种特殊的血管内模式与细胞学评估相结合是否可作为诊断性脾切除术的一种实用替代方法，必须通过聚焦于此免疫组化标准的广泛研究来证实。
