Nasopharyngeal and nasal malignant lymphoma: a clinicopathological study of 54 cases

Forty-one cases of nasopharyngeal and 13 cases of nasal malignant lymphoma have been examined histologically and immunohistochemically. All of the cases were non-Hodgkin's lymphoma; one case was of follicular type and the remaining 53 were of diffuse type. Large cell lymphoma comprised 48% of cases and most of the immunoblastic lymphomas showing pleomorphism occurred in the nose. Twenty-seven cases were of T-cell and 21 of B-cell phenotype. The predominance of T-cell lymphoma was due to an increased incidence of these in the nose, the T:B ratio of 3.33:1 contrasting with a 1:1.05 ratio in the nasopharynx. Nasopharyngeal lymphomas seem to show an intermediate incidence between the T-cell predominance in the nose and a B-cell predominance in the oropharynx. Since the large cell type of lymphoma was predominant, the differential diagnosis from undifferentiated carcinoma is important and is facilitated by the use of immunostaining methods.     

脾原发性淋巴瘤超微结构观察与流式细胞分析

目的 探讨诊断电镜（DEM）对脾原发性淋巴瘤的病理分型的超微结构特征。流式细胞术（FCM）测定瘤细胞DNA倍性与恶性程度的关系。方法 应用透射电镜和流式细胞术观察分析41例脾原发性淋巴瘤的超微结构和瘤细胞DNA倍性。结果41例脾原发性淋巴瘤中霍奇金淋巴瘤5例,电镜下R-S细胞呈双叶不规则核和对称致密大核仁,核内常染色质明显,胞质内见中等量线粒体,较长的粗面内质网。非霍奇金B细胞性淋巴瘤21例,裂细胞性5例,细胞核大,核伴有较深的裂沟,胞浆少,胞质见少数肿胀线粒体,无核裂细胞性7例,细胞核规则,呈圆或卵圆型,异染色质多呈条块状,核仁中等大,胞质少,见少量线粒体及长粗面内质网。混合细胞性,瘤细胞大小悬殊,大畸形核较多,核扭曲,不规则深沟及不对称分叶,形成多叶核。非霍奇金T免疫母细胞淋巴瘤11例,瘤细胞较大,核小胞质相对多,胞质透明,核多形性,有的呈圆或卵圆形,核膜薄,有深浅不一的凹陷,可见小核仁。淋巴母细胞性5例,淋巴母曲核性淋巴瘤,细胞为中小形,呈锯齿状核和扭曲状核,异染色质沿核膜聚集,核仁小。毛细胞性淋巴瘤1例,毛细胞的绒毛宽基底,核仁大,胞浆无核糖体板层复合物。组织细胞性淋巴瘤3例,细胞浆丰富,核圆或椭圆形,偶见核膜呈锯齿状或折叠,线粒体和溶酶体丰富,无细胞连接和Birbeck颗粒。FCM     

B细胞淋巴瘤石蜡包埋组织克隆性重链基因重排检测

目的 探讨克隆性重链基因重排检测在B细胞淋巴瘤(B—NHL)诊断中的价值。方法 用半巢式聚合酶链反应(semi—nested PCR)、聚丙烯酰胺凝胶电泳(PAGE)及银染技术，检测经形态学及免疫组织化学确诊的23例B—NHL石蜡包埋组织标本的克隆性免疫球蛋白第三互补决定区(IgHCDR3)重排基因，对照组为7例T细胞淋巴瘤(T—NHL)及6例反应性增生或肉芽肿性淋巴结炎。结果 B—NHL IgHCDR3检出的阳性率87．0％(20／23)，假阳性率7．7％(1／13)，假阴性率13．0％(3／23)。结论 检测克隆性IgHCDR3重排为B—NHL的诊断及鉴别诊断提供有效的辅助手段。     

Malignant lymphoma. Pathology, diagnosis, therapy

Summary Malignant lymphomas can be subdivided into Hodgkin's disease and low- or high-grade non-Hodgkin's lymphoma (NHL). The principal therapeutic options are polychemotherapy and radiotherapy. Besides the histological classification, staging of the disease with particular regard to risk factors is an essential prerequisite for the therapeutic decision. Diagnostic imaging modalities such as computer tomography, magnetic resonance imaging, and ultrasonography have improved the accuracy of clinical staging such that invasive pathological staging is only necessary in exceptional cases. A novel therapeutic approach is high-dose chemotherapy with autologous haematopoietic stem-cell support. This treatment improves the survival of patients with relapsed high-grade NHL. The place of high-dose therapy as the primary therapeutic option in malignant lymphoma is now being assessed in prospective studies following encouraging results from single-centre studies, including those involving the treatment of low-grade lymphoma. The effects of antibodies directed against lymphatic cells are currently being examined in experimental treatments. An assessment of the viability and rate of proliferation of lymphoma tissue on completion of therapy using sensitive radiological and nuclear medical methods is an important aim for the future. Eingegangen am 5. November 1996 Angenommen am 12. November 1996     

Primary gastrointestinal lymphomas in Turkey: a retrospective analysis of clinical features and results of treatment.

Thirty-three patients with primary gastrointestinal lymphoma (GIL) followed at Ankara University Medical School have been evaluated. The most frequent locations of the disease are the small intestine (48.4%) and the stomach (39.3%). The intermediate and high grade lymphomas constitute 84.8% of the cases. The mean age of the patients with small intestinal lymphoma is 28.7 years and 47.1 years for those with gastric lymphoma. The patients treated with surgery and chemotherapy (S+CT) have a longer survival than those treated with chemotherapy (CT) alone. In conclusion: 1) Small intestinal lymphoma occurs more frequently than gastric lymphoma in our study. 2) The median age of the Turkish patients with primary GIL is approximately 10 years less than those in the Western countries. 3) The therapeutic results of S+CT are superior to those of CT in the early stages of the disease.     

Distribution of extracellular matrix components and their receptors in human lymphoid tissue and B-cell non-Hodgkin lymphomas

In this study the distribution patterns of various extracellular matrix components and their receptors (i.e. β1 integrins) in B-cell non-Hodgkin lymphomas were examined and compared to those in reactive lymphoid tissue. Neoplastic follicles within follicular lymphomas showed similar patterns to that observed in reactive follicles, which appeared to be strongly associated with the presence of follicular dendritic cells. Diffuse lymphomas of low and intermediate malignancy grade revealed features comparable to those of interfollicular areas of reactive lymphoid tissue, irrespective to which compartment the tumour cells were related. Highly malignant lymphomas, however, displayed unique extracellular matrix configurations, resulting from active matrix degradation by macrophages; this may support rapid tumour growth. Extranodal lymphomas showed virtually the same matrix patterns as their nodal counterparts, suggesting that (malignant) lymphoid cells generate (at least partly) their own specific microenvironment. In reactive lymphoid tissue β1 integrins were mainly found on resident cells and except for α4, α5 (and β1) the lymphoid cells expressed very little, if any, β1 integrins. In comparison, expression of these integrins on lymphoma cells was reduced (follicular lymphomas) or could not be detected at all (diffusely growing lymphomas); this might contribute to the growth pattern and metastatic properties of the tumours.     

Primary lymphoma of the mandible with diffuse widening of the mandibular canal: report of a case

A case of primary non-Hodgkin's lymphoma (NHL) of the mandible with unusual radiographic presentation is reported. The panoramic radiography revealed diffuse widening of the right mandibular canal with ill-defined margins and absence of edge sclerosis. Computed tomography showed infiltration of the superior portion of the canal with involvement of the vestibular cortex of the bone and of the alveolar ridge. Correspondence to: M. Bertolotto     

Leukemia,lymphoma, and multiple myeloma following selected medical conditions

The role of selected prior medical conditions in the etiology of hematopoietic malignancies was examined in a case-control study of members of two regional branches of the Kaiser Permanente Medical Care Program (USA). Past history of chronic infectious, autoimmune, allergic, and musculoskeletal disorders was abstracted from medical records for leukemia (n = 299), non-Hodgkin's lymphoma (NHL, n = 100), and multiple myeloma (n = 175) cases and matched controls (n = 787). Little difference was found between cases and controls for most of the chronic conditions evaluated, including sinusitis, carbuncles, urinary tract infections, pelvic infections, herpes zoster, asthma, rheumatoid arthritis, psoriasis, bursitis, and gout. Only three statistically significant elevated risks were found, i.e., with combined disc disease myeloma among patients with prior eczema and disk and other musculoskeletal conditions, and NHL following tuberculosis. Only two of these associations showed consistent patterns by sex and geographic region (myeloma with eczema and with musculoskeletal conditions). While prior history of eczema and musculoskeletal conditions may slightly increase risk of myeloma, this study provided little if any support for an association of chronic infectious, autoimmune, allergic, and musculoskeletal conditions with subsequent occurrence of the leukemias or NHL. Additionally, these data did not support a role for chronic antigenic stimulation, as defined in previous epidemiologic studies, in the etiology of hematopoietic malignancies.Ms Doody and Drs Linet, Pottern, Boice, and Fraumeni are with the Epidemiology and Biostatistics Program, National Cancer Institute. Dr Glass is with the Kaiser Permanente Medical Care Program, Northwest Region, Portland, Oregon, USA. Dr Friedman is with the Kaiser Permanente Medical Care Program, Northern California Region, Oakland, California, USA. Address correspondence to Ms Doody, Radiation Epidemiology Branch, National Cancer Institute, Executive Plaza North, Room 408, Bethesda, MD 20892, USA. This research was supported in part by National Cancer Institute contracts NO1-CP-01047, NO1-CP-01054, NO1-CP-11009, NO1-CP-11037, NO1-CP-31035, and NO1-CP-61006.     

High-grade T-cell lymphoma following treatment with cyclosporin A

A 47-year-old man with persistent severe oropharyngeal ulceration developed a high-grade T-cell lymphoma soon after commencing treatment with cyclosporin A. Using Southern blotting to identify T-cell beta-chain gene rearrangements, evidence of clonal restriction was found both in blood and lymph node DNA samples. Two BamH1 rearranged bands were demonstrated in both samples. In the blood a 16 Kb band predominated, with a weaker 28 kb band. In the lymph node sample this pattern was reversed. The findings suggest that a bi-clonal population of T-lymphocytes or clonal evolution of an existing T-cell monoclone had developed, and that cyclosporin contributed to the emergence of a high-grade T-cell lymphoma.