Cohen P L, Kurtin P J, Donovan K A, Hanson C A
Division of Hematopathology, Mayo Clinic, Rochester, Minnesota 55905, USA.
Br J Haematol. 1998 May;101(2):302-10. doi: 10.1046/j.1365-2141.1998.00684.x.
The peripheral blood smears, bone marrow aspirates and biopsies of 46 patients with mantle cell lymphoma were reviewed. The diagnosis of mantle cell lymphoma was established in all cases on extramedullary tissue samples using standard morphologic, phenotypic and molecular genetic criteria. 27/35 patients (77%) had circulating lymphoma cells (median 200%m of all circulating white blood cells; range 5-90%) identified by morphology at some point during the course of their disease. No statistical difference in survival was detected in patients with or without peripheral blood involvement. Lymphoma was identified in bone marrow aspirate specimens from 33/40 patients (83%) and in bone marrow biopsy specimens from 39/43 patients (91%). The pattern of marrow biopsy involvement was nodular (31 cases; 82%), interstitial (19 cases; 50%), paratrabecular (17 cases, 45%) and diffuse (12 cases; 32%). Although the median survival of patients with > or = 50% bone marrow involvement was 13 months, and the median survival of patients with < or = 50% was 49 months; no statistically significant differences between these small subgroups were observed. Mantle cell lymphoma frequently involves the peripheral blood and bone marrow. Its appearance is distinctive but variable, and immunophenotypic studies as well as morphologic confirmation by a biopsy of tissue other than bone marrow is still required for diagnosis.
回顾了46例套细胞淋巴瘤患者的外周血涂片、骨髓穿刺及活检结果。所有病例均根据标准的形态学、表型及分子遗传学标准，在外周组织样本中确诊为套细胞淋巴瘤。27/35例患者（77%）在病程中的某些时间点通过形态学检查发现循环淋巴瘤细胞（占所有循环白细胞的中位数为200%；范围为5%-90%）。外周血受累与未受累患者的生存率无统计学差异。在40例患者中的33例（83%）骨髓穿刺标本及43例患者中的39例（91%）骨髓活检标本中发现淋巴瘤。骨髓活检受累模式为结节状（31例；82%）、间质型（19例；50%）、小梁旁型（17例，45%）及弥漫型（12例；32%）。尽管骨髓受累≥50%的患者中位生存期为13个月，骨髓受累≤50%的患者中位生存期为49个月，但在这些小亚组之间未观察到统计学显著差异。套细胞淋巴瘤常累及外周血和骨髓。其表现独特但具有变异性，诊断仍需免疫表型研究以及骨髓以外组织活检的形态学确认。
