Walz-Mattmüller R, Horny H P, Ruck P, Kaiserling E
Institute of Pathology, University of Tübingen, Germany.
Pathol Res Pract. 1998;194(11):781-9. doi: 10.1016/S0344-0338(98)80068-X.
The incidence and pattern of liver involvement in 127 liver specimens (2 biopsy and 125 autopsy specimens) from cases of acute myelogenous leukaemia (25), chronic myelogenous leukaemia (7), acute lymphatic leukaemia (5), chronic lymphatic leukaemia (9), multiple myeloma (25), low-grade non-Hodgkin's lymphoma (25), high-grade non-Hodgkin's lymphoma (24) and myeloproliferative diseases (7) were investigated histologically and immunohistochemically. Liver infiltration was found frequently in chronic leukaemia and myeloproliferative diseases (80-100%), acute leukaemia (60-70%) and non-Hodgkin's lymphoma (50-60%), but was significantly less common in multiple myeloma (32%) than in any of the other diagnostic groups. Hepatomegaly was found in over 50% of cases in all the diagnostic groups, but was not always associated with infiltration. Diffuse, non-destructive infiltration was most common: in acute myelogenous leukaemia, both the portal triads and sinusoids were usually involved; in chronic myelogenous leukaemia, multiple myeloma and myeloproliferative diseases, infiltration was mainly sinusoidal; and in lymphatic leukaemia and non-Hodgkin's lymphoma the portal triads were mainly involved. Nodular infiltration was seen in multiple myeloma and non-Hodgkin's lymphoma. The primary tumours and liver infiltrates generally exhibited the same immunophenotype, although reactivity with the antibody L26 (CD20) was only found in the primary lesion in many high-grade B-cell lymphomas. Thus, liver involvement is common in haematological malignancies, but the incidence and pattern of infiltration vary amongst the different types.
对127例肝脏标本（2例活检标本和125例尸检标本）进行了组织学和免疫组织化学研究，这些标本来自急性髓性白血病（25例）、慢性髓性白血病（7例）、急性淋巴细胞白血病（5例）、慢性淋巴细胞白血病（9例）、多发性骨髓瘤（25例）、低度非霍奇金淋巴瘤（25例）、高度非霍奇金淋巴瘤（24例）和骨髓增殖性疾病（7例）患者，以探究肝脏受累的发生率和模式。在慢性白血病和骨髓增殖性疾病（80%-100%）、急性白血病（60%-70%）和非霍奇金淋巴瘤（50%-60%）中，肝脏浸润较为常见，但在多发性骨髓瘤（32%）中明显少于其他任何诊断组。在所有诊断组中，超过50%的病例发现肝肿大，但肝肿大并不总是与浸润相关。弥漫性、非破坏性浸润最为常见：在急性髓性白血病中，门三联和肝血窦通常均受累；在慢性髓性白血病、多发性骨髓瘤和骨髓增殖性疾病中，浸润主要在肝血窦；在淋巴细胞白血病和非霍奇金淋巴瘤中，门三联主要受累。在多发性骨髓瘤和非霍奇金淋巴瘤中可见结节性浸润。尽管在许多高度B细胞淋巴瘤中仅在原发灶发现与抗体L26（CD20）反应，但原发肿瘤和肝脏浸润通常表现出相同的免疫表型。因此，肝脏受累在血液系统恶性肿瘤中很常见，但不同类型之间浸润的发生率和模式有所不同。
