ACM  >> Vol. 3 No. 4 (December 2013)

    结节性淋巴细胞优势型霍奇金淋巴瘤的诊断与鉴别诊断
    The Diagnosis and Differential Diagnosis of Nodular Lymphocyte Predominant Hodgkin Lymphoma(NLPHL)

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作者:  

张 燕,谢欣焱,柏任犁,卡力比努.艾合买提江:新疆伊犁哈萨克自治州妇幼保健院病理科,伊宁;
李 青:新疆伊犁哈萨克自治州妇幼保健院病理科,伊宁;南京医科大学附属南京市妇幼保健院病理科,南京

关键词:
结节性淋巴细胞优势型霍奇金淋巴瘤诊断鉴别诊断Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL); Diagnosis; Differential Diagnosis

摘要:

目的:对结节性淋巴细胞优势型霍奇金淋巴瘤进行准确分类,因为各型霍奇金淋巴瘤的治疗和预后各不相同。方法:通过分析结节性淋巴细胞优势型霍奇金淋巴瘤有效的组织学特征和免疫表型,明确结节性淋巴细胞优势型霍奇金淋巴瘤与经典型霍奇金淋巴瘤、T细胞/富于组织细胞的大B细胞淋巴瘤,滤泡性淋巴瘤(旺炽变化)和生发中心进行性转化滤泡增生之间的鉴别诊断。结果依据形态学特征和免疫表型结果,可对手术切除的活检标本进行结节性淋巴细胞优势型霍奇金淋巴瘤的诊断。结论:需综合临床病史、组织学特征和免疫表型对结节性淋巴细胞优势型霍奇金淋巴瘤进行合理诊断。

Objective: The aim of this paper is to make the accurate classification of Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL), because every type of NLPHL has its distinct therapeutic and prognostic implications. Methods: To diagnose NLPHL and make clear the differential diagnosis among NLPHL, classical Hodgkin lymphoma, T-cell/histiocyte-rich large B-cell lymphoma, follicular lymphoma (floral variant), and follicular hyperplasia with progressive transformation of germinal centers, histologic and immunophenotypic features were analyzed. Results: With the morphologic and IHC phenotype, the diagnosis of NHPHL can be made on excisional biopsies. Conclusion: Clinical, histologic, and IHC features are essential in accurate diagnosis of NLPHL.

文章引用:
张燕, 谢欣焱, 柏任犁, 卡力比努.艾合买提江, 李青. 结节性淋巴细胞优势型霍奇金淋巴瘤的诊断与鉴别诊断[J]. 临床医学进展, 2013, 3(4): 33-36. http://dx.doi.org/10.12677/ACM.2013.34009

参考文献

[1] Khoury, J.D., Jones, D., Yared, M.A., Manning Jr. J.T., Abruzzo, L.V., Hagemeister, F.B. and Medeiros, L.J. (2004) Bone marrow involvement in patients with nodular lymphocyte predominant Hodgkin lymphoma. The American Journal of Surgical Pathol- ogy, 28, 489-495.
[2] Biasoli, I., Stamatoullas, A., Meignin, V., Delmer, A., Reman, O., Morschhauser, F., Coiffier, B., Bosly, A., Divine, M. and Brice, P. (2010) Nodular, lymphocyte-predominant Hodgkin lymphoma: A long-term study and analysis of transformation to diffuse large B-cell lymphoma in a cohort of 164 patients from the Adult Lymphoma Study Group. Cancer, 116, 631-639.
[3] Fan, Z., Natkunam, Y., Bair, E., Tibshirani, R. and Warnke, R.A. (2003) Characterization of variant patterns of nodular lympho- cyte predominant hodgkin lymphoma with immunohistologic and clinical correlation. The American Journal of Surgical Pathology, 27, 1346-1356.
[4] Krishnan, C., Warnke, R.A., Arber, D.A. and Natkunam, Y. (2010) PD-1 expression in T-cell lymphomas and reactive lym- phoid entities: Potential overlap in staining patterns between lymphoma and viral lymphadenitis. The American Journal of Surgical Pathology, 34, 178-189.
[5] Diehl, V., Sextro, M., Franklin, J., Hansmann, M.L., Harris, N., Jaffe, E., Poppema, S., Harris, M., Franssila, K., van Krieken, J., Marafioti, T., Anagnostopoulos, I. and Stein, H. (1999) Clinical presentation, course, and prognostic factors in lymphocyte-pre- dominant Hodgkin’s disease and lympho-cyte-rich classical Hodgkin’s disease: Report from the European Task Force on Lymphoma Project on Lymphocyte-Predominant Hodgkin’s Disease. Journal of Clinical Oncology, 17, 776-783.
[6] Boudova, L., Torlakovic, E., Delabie, J., Reimer, P., Pfistner, B., Wiedenmann, S., Diehl, V., Muller-Hermelink, H.K. and Rudiger, T. (2003) Nodular lymphocyte-predominant Hodgkin lymphoma with nodules resembling T-cell/histiocyte-rich B-cell lymphoma: differential diagnosis between nodular lymphocyte-predominant Hodgkin lymphoma and T-cell/histiocyte-rich B-cell lymphoma. Blood, 102, 3753-3758.
[7] Huang, J.Z., Weisenburger, D.D., Vose, J.M., Greiner, T.C., Aoun, P., Chan, W.C., Lynch, J.C., Bierman, P.J. and Armitage, J.O. (2003) Diffuse large B-cell lymphoma arising in nodular lymphocyte predominant hodgkin lymphoma. A report of 21 cases from the Nebraska Lymphoma Study Group. Leukemia & Lymphoma, 44, 1903-1910.
[8] Al-Mansour, M., Connors, J.M., Gascoyne, R.D., Skinnider, B. and Savage, K.J. (2010) Transformation to aggressive lymphoma in nodular lymphocyte-predominant Hodgkin’s lymphoma. Journal of Clinical Oncology, 28, 793-799.
[9] Huang, J.Z., Weisenburger, D.D., Vose, J.M., Greiner, T.C., Aoun, P., Chan, W.C., Lynch, J.C., Bierman, P.J. and Armitage, J.O. (2004) Diffuse large B-cell lymphoma arising in nodular lymphocyte predominant Hodgkin lymphoma: A report of 21 cases from the Nebraska Lymphoma Study Group. Leukemia & Lymphoma, 45, 1551-1557.
[10] Rueffer, U., Josting, A., Franklin, J., May, M., Sieber, M., Breuer, K., Engert, A. and Diehl, V. (2001) Non-Hodgkin’s lymphoma after primary Hodgkin’s disease in the German Hodgkin’s Lym- phoma Study Group: Incidence, treatment, and prognosis. Jour- nal of Clinical Oncology, 19, 2026-2032.