恶性淋巴瘤的超微病理学研究

应用透射电镜对４２例恶性淋巴瘤（ＭＬ）的超微结构进行了观察分析，其中３４例（８１％）的电镜亚型分类结果与病理分类一致，其中６例非霍奇金淋巴瘤（ＮＨＬ）的亚型分类以电镜更为正确，另２例由于电镜取材不适，将霍奇金病（ＨＤ）误认为ＮＨＬ，复查病理后修正了电镜诊断。本组病理分类准确率为８５％，而结合电镜观察其亚型分类准确率高９５％。研究结果认为病理分类、免疫分型及电镜观察三者结合应用，可提高ＭＬ的诊断及亚     

408例非霍奇金淋巴瘤侵犯骨髓与并发白血病的临床观察

目的：观察非霍奇金淋巴瘤（ＮＨＬ）骨髓侵犯（ＢＭＩ）或并发淋巴瘤细胞性白血病（ＬＭＣＬ）后９种变量为预后的关系。方法：地４０８例ＮＨＬ的９种变理与预后的关系进行了对比分析。结果：ＮＨＬ出现骨髓受累后与未受累组１ａ、３４ａ和５ａ的生存率有显著性差异，ＢＭＩ或ＬＭＣＬ患者的预后与多种因素相关，其中早期诊断和合理化疗是长期存主要可操作因素之一。结论：ＮＨＬ出现ＢＭＩ或ＬＭＣＬ后预后较差，特别是ＬＭＣＬ治     

恶性淋巴瘤现代治疗策略

恶性淋巴瘤（ＭＬ）通常指霍奇金淋巴瘤（ＨＤ）与非霍奇金淋巴瘤（ＮＨＬ）为主的两大类肿瘤，在病理分类方面，ＨＤ一直沿用１９６５年Ｒｙｅ会议制定的分类，该分类简单明了，易记，且能提示预后；而ＮＨＬ则因属于高度不均一性疾病，其发生发展比ＨＤ更混乱，更复杂，...     

淋巴良恶性增生性病变与EB病毒感染关系的研究

应用多聚酶链反应（ＰＣＲ）技术检测霍奇金淋巴瘤（ＨＬ）、非霍奇金淋巴瘤（ＮＨＬ）、组织细胞坏死性淋巴结炎（ＨＮＬ）和非特异性慢性淋巴结炎（ＮＣＬ）几种淋巴结增生病普中ＥＢ病毒ＤＮＡ。结果显示：几种病变中ＥＢ病毒ＤＮＡ的检出率分别为：ＨＬ１８／３７（４８．６％），各亚型中ＬＰ２／７（２８．６％），ＮＳ２／１０（２０％），ＭＣ９／１２（７５％），ＬＤ５／８（６２．５）；ＮＨＬ１／８（１２．５％）；ＨＮＬ３／５（６０％）；ＮＣＬ３／１１（２７．３％）。结果提示国内ＨＮＬ和ＨＬ的发病可能与ＥＢ病毒感染的关系密切。     

非霍奇金淋巴瘤侵犯骨髓的病理与临床研究

目的 探讨非霍奇金淋巴瘤（ＮＨＬ）侵犯骨髓（ＢＭＩ）的病理形态学特点及与临床表现的关系。方法 骨髓活检塑料包埋切片，Ｈ－Ｇｉｅｍｓａ－Ｅ染色及免疫组化确定淋巴瘤表现。７０例ＮＨＬＢＭＩ中，男５２例，女１８例。中位年龄４９（４～７８）岁。Ｔ－ＮＨＬ２０例，Ｂ－ＮＨＬ５０例。结果 ＮＨＬＢＭＩ呈轻度１５例（２１．４％），中度１６例（２２．９％），重度３９例（５５．７％）。瘤细胞分布呈间质型２３例（３２．９％），结节型７例（１０．０％），混合型１８例（２５．７％）和弥漫型２２例（３１．４％）。结节型侵犯伴脾肿大者显著高于其他型，结节型者主要为Ｂ－ＮＨＬＢＭＩ，表明ＮＨＬＢＭＩ伴脾肿大与淋巴瘤表型有关。显著侵犯组易合并淋巴瘤细胞白血病（ＬＣＬ），表明ＮＨＬＢＭＩ越重，越易合并ＬＣＬ。还提示淋巴瘤侵犯骨髓越轻，疗效越好。     

非霍奇金淋巴瘤中枢神经系统侵犯的预防

非霍奇金淋巴瘤中枢神经系统侵犯的预防熊梅常瑛首都医科大学附属北京友谊医院血液科（北京市１０００５０）非霍奇金淋巴瘤（ＮＨＬ）中枢神经系统侵犯（ＣＮＳＬ）是死亡率很高的并发症。我院近年共收治ＮＨＬ２０例，３例因ＣＮＳＬ死亡，其中２例初发位于颈部浅淋巴结...     

100例非霍奇金淋巴瘤分类与预后关系的研究

应用形态学标准与免疫组织化学方法对１００例非霍奇金淋巴瘤（ＮＨＬ）的分类与预后关系进行了研究。在ＮＨＬ中，细胞分类的百分率如下：Ｂ细胞６６％，Ｔ细胞２９％，非Ｂ非Ｔ细胞２％，组织细胞３％。根据形态学的标准，Ｔ与Ｂ淋巴瘤的肿瘤细胞可被分别分为四与六种亚型。详细地描述了每种亚型的形态学特征。随访结果表明了Ｂ细胞淋巴后的预后比Ｔ细胞淋巴瘤好。淋巴瘤的正确分类有助于病人的治疗。作者建议对淋巴母细胞与中心母细胞类型的ＮＨＬ需要进行积极的化疗与放疗。     

北欧儿童NHL20年流行病学研究

瑞典保健组织和儿童恶性肿瘤登记中心调查了２０年来儿童非霍奇金淋巴瘤（ＮＨＬ）的发病率、临床病理学特征、预后危险因素及长期生存率。调查对象为１９７５年～１９９４年在瑞典西部地区诊断的ＮＨＬ儿童。结果显示，１５岁以下儿童ＮＨＬ年发病率为 ９／１００万小儿，占调查期间全部儿童恶性肿瘤的６％，男女之比为４．１：１．０。７７例ＮＨＬ患儿中，６４例做了免疫学标志物检查，其中４１例为Ｂ细胞淋巴瘤，１７例为Ｔ细胞淋巴瘤，６例为Ｋｉ－ｌ阳性退化大细胞淋巴瘤（ＡＬＣＬ）。２例Ｋｉ－ｌ阳性ＡＬＣＬ病儿原先认为分别为恶…     

原发性喉恶性淋巴瘤19例临床分析

目的 根据１９例原发性喉恶性淋巴瘤，结合文献分析该病的临床、病理、治疗及预后。方法 １９例中声门上区１４例，声门区５例。间接喉镜或纤维喉镜下呈粘膜光滑肿瘤１４例，坏死糜烂性改变５例，病理均为非霍奇金淋巴瘤（ＮＨＬ）。Ｂ细胞ＮＨＬ９例，Ｔ细胞ＮＨＬ１０例，其中中线Ｔ细胞ＮＨＬ５你，治疗均以放射治疗为主，采用６ＭＶＸ照射或＾６０Ｃｏγ照射，以局部野为主，照射野后部分加照９～１２ＭｅＶ电子线。放射治疗前     

非霍奇金氏淋巴瘤骨髓微小病灶检测的临床意义

目的：探讨微小病灶非霍金氏淋巴瘤中的检测对病人疗效、预后的影响。方法：采有ＰＣＲ方法扩增Ｔ细胞受体γ链（ＴＣＲγ）和免疫球蛋白重链（ＩgＨ）基因重排，对１３例骨 髓形态学检查正常的Ｔ，细胞非霍奇金氏淋巴瘤（Ｔ－ＮＨＬ）和１７例Ｂ细胞非霍奇金氏淋巴瘤（Ｂ－ＮＨＬ）病人治疗前骨髓标本进行微小病灶（ＭＲＤ）检测。结果：其中７例Ｔ－ＮＨＬ病人发生ＴＣＲγ基因重排，检出率为５３．８％，１１例Ｂ－ＮＨＬ病人发生     

Significance of electron microscopy in differential diagnosis of small cell neoplasms]

The diagnosis of small cell anaplastic neoplasms is one of the difficult problems in routine pathology. In some cases, it is almost impossible by light microscopy (LM) to arrive at a correct diagnosis. Electron microscopy (EM) may contribute greatly in solving this problem. However, it is impractical to make EM examination as a routine in every difficult neoplasm. Therefore, we have reviewed, by EM specimens of 21 cases (9 cases of small cell carcinoma and 12 cases of lymphoma, previously diagnosed by LM in this hospital), and compared the light and ultrastructural features of these tumors. We found that the most important light microscopic feature to differentiate lymphoma from small cell carcinoma is the nuclear structure of tumor cells. According to the characteristics such as the shape of nuclei, the distribution of chromatin, the stereoscopic impression of nuclear section plane while focusing, the appearance of nucleoli, it is often possible to arrive at a correct diagnosis of lymphoma or small cell carcinoma by LM.     

恶性淋巴瘤并发特发性血小板减少性紫癜5 例报告

 目的　探讨恶性淋巴瘤 (ML)并发特发性血小板减少性紫癜 (ITP)的诊断与治疗。方法　通过本组病例分析 ML并发 ITP的诊断治疗。结果　本组资料 ML50 0例中并发 ITP5例 ,其中 NHL4例 ,HD1例 ,发生率为 1 % ;ML并发 ITP可于 ML诊断之前、两者同时发生或于肿瘤治疗缓解多年以后发生。强的松或联合化疗可使 ITP缓解 ,但与肿瘤反应不完全平行。结论　提出ML患者并发血小板减少的诊断及合理选择治疗的重要意义。     

SIGNIFICANCE OF ELECTRON MICROSCOPIC EXAMINATION IN THE DIAGNOSIS OF PULMONARY NEOPLASMS

ＳＩＧＮＩＦＩＣＡＮＣＥＯＦＥＬＥＣＴＲＯＮＭＩＣＲＯＳＣＯＰＩＣＥＸＡＭＩＮＡＴＩＯＮＩＮＴＨＥＤＩＡＧＮＯＳＩＳＯＦＰＵＬＭＯＮＡＲＹＮＥＯＰＬＡＳＭＳ￥ＴｏｎｇＭａｏｒｏｎｇ；童茂荣；ＺｈｏｕＸｉａｏｊｕｎ；周晓军；ＫａｎｇＸｉａｏｍｉｎｇ；康...     

Electron microscopy in small cell lung carcinomas: clinical correlation

In order to investigate the relationship of subcellular differentiation of small cell lung carcinomas (SCLC) and clinical response, we reviewed the electron microscopic (EM) features of tumor biopsy specimens from 33 patients with SCLC diagnosed by light microscopy (LM). These tumors were divided by EM into four groups according to the ultrastructural features. Group I (13 patients) had tumors with only neurosecretory granules on EM. Group II (11 patients) had tumors with neurosecretory granules and other subcellular features of non-SCLC. Group III (five patients) had tumors that lacked neurosecretory granules but contained subcellular features of non-SCLC. Group IV (four patients) had tumors that lacked all of these features. The complete and partial response rate to systemic chemotherapy with or without radiation therapy was 88% in the total population studied. The response rates were not statistically different in any of the four groups based on EM findings. The results of this study suggest that the LM diagnosis of SCLC alone adequately identifies lung cancer patients with a high response rate to systemic therapy.     

44例儿童恶性淋巴瘤的免疫病理分类及临床病理分析

本文对４４例儿童恶性淋巴瘤进行免疫病理分类和临床病理分析。结果表明，临床主要表现浅表淋巴结肿大，消溲，苍白，发热及腹腔肿块，非何杰金氏淋巴瘤３３例，全部为弥漫 型，其中Ｂ淋巴瘤１８例，裂，无裂细胞性和无裂细胞性各７例；Ｔ淋巴瘤１４例，大部分为淋巴母细胞性；组织细胞性１例。     

UV radiation exposure, skin type and lymphoid malignancies: results of a French case–control study

Objectives Investigating the relationship between skin type, UV exposure, and lymphoid malignancies (LM). Methods We conducted a hospital-based case–control study in France, including 813 incident cases of non-Hodgkin’s lymphoma (NHL), Hodgkin’s lymphoma (HL), lymphoproliferative syndrome (LPS) or multiple myeloma and 748 controls. Results Positive associations between HL and blond/red hair (OR = 1.8 [0.8–3.8]), very fair/fair skin (OR = 1.6 [1.0–2.5]) were observed. High propensity to burn was associated with HL (OR = 1.5 [1.0–2.2]) and LPS (OR = 1.4 [1.0–2.1]). Poor ability to tan was significantly associated with HL (OR = 1.7 [1.0–2.8]). Having light hair with high propensity to burn was associated with NHL (OR = 1.5 [0.9–2.5]) and significantly with HL (OR = 3.4 [1.4–8.4]). Having dark hair with high propensity to burn was significantly associated with LPS (OR = 1.5 [1.0–2.2]). The associations with HL and NHL were significant for men only, with significant interactions. Outdoors activities since leaving school or in the last decade were not related to LM. Only an almost negative trend was observed. Prior exposure to artificial UV was not associated with LM. Conclusion These results suggest a positive association between the most reactive and palest skin types and NHL or HL in men and do not rule out a slight negative relationship between UV exposure and LM.     

Association between obesity and the risk of malignant lymphoma in Japanese: a case–control study

Although marked differences in anthropometric characteristics and malignant lymphoma (ML) incidence suggest that the association between obesity and ML risk in Asian and non‐Asian populations may differ, few studies have investigated this association in Asian populations. Here, we conducted a sex‐ and age‐matched case–control study in a Japanese population using 782 cases and 3,910 noncancer controls in the hospital‐based Epidemiological Research Program at Aichi Cancer Center Hospital. Odds ratios (ORs) and 95% confidence intervals (CIs) for anthropometric characteristics were estimated using a conditional logistic regression model that incorporated smoking and alcohol intake. Recent body weight and body mass index (BMI) showed marginally significant association with ML risk (ORs [95% CIs] per 5‐unit increase in recent weight and BMI; 1.04 [0.99–1.09] and 1.11 [0.98–1.27], respectively). On the other hand, weight and BMI in early adulthood exhibited a strong association with ML risk (ORs [95% CIs] per 5‐unit increase in early adulthood weight and BMI; 1.11 [1.05–1.18] and 1.33 [1.13–1.55], respectively). Further, in women, a BMI of 25.0–29.9 kg/m², defined as obesity in Asian populations, during early adulthood was significantly associated with ML risk compared to the normal range of 18.5–22.9 kg/m². By histological ML subtype, the point estimates of ORs for obesity relative to normal weight in early adulthood were over unity for non‐Hodgkin lymphoma (NHL) as a whole and significant for diffuse large B‐cell lymphoma (DLBCL). In conclusion, our study in Japanese subjects suggested that early adulthood obesity is associated with the risk of NHL, particularly DLBCL.     

Immunoblastic lymphosarcoma: a light, immunofluorescence, and electron microscopic study.

Immunoblastic lymphosarcoma (ILS) is a newly recognized malignant lymphoreticular neoplasm and is included in the recent W.H.O. classification of lymphomas. This report concerns six cases of ILS studied by light, immunofluorescence (IF), and electron microscopy (EM). Four patients were female and all except one were over 50 years of age. Four patients had some immunological abnormality. Light microscopy showed a monomorphic population of immunoblasts with pyroninophilic cytoplasm and variable plasmacytoid differentiation. Intracytoplasmic IgG was demonstrated by IF in four cases, and IgA in one. Large lymphoid cells with varying proportions of polysomes, rough endoplasmic reticulum, and Golgi apparatus were seen by EM in four cases. Mean survival was 4.8 months in five cases; death in four was due to disseminated ILS. We concluded that our cases of ILS are of B cell origin, are often associated with immunological abnormalities, and carry a poor prognosis. Immunofluorescence and EM are helpful in its diagnosis.     

Pathogenesis of malignant lymphomas in intravenous drug-abuser, HIV-infected patients

To study the pathogenesis of malignant lymphomas (ML) in intravenous drug-abuser HIV-infected patients, we analyzed 19 cases of reactive lymphadenopathy (LAS) and 10 cases of ML. Clonality and differences in characteristics of these lymphoproliferative disorders were investigated by immunohistochemical and Ig and TCR gene rearrangement analyses. Rearrangements at the c-myc locus and presence of HIV and EBV viral genomes were also investigated. Four out of the five non-Hodgkin's lymphomas (NHL) analyzed were high-grade extranodal ML and were found to derive from precursor B cells. Monoclonal cell expansions were also detected in 2 cases of LAS. These cell expansions also consisted of precursor B cells. HIV genome was not detected in any of the samples tested and was therefore considered not to be involved as an etiological agent in these lymphoproliferative disorders. EBV genome was present in a clonal episomal form in the five Hodgkin's disease (HD) specimens tested. This finding suggested that a clonal cell population harboring the EBV viral genome must be present in HDs, pointing to a possible etiological relationship between EBV and HD in HIV-infected patients.     

Malignant myoepithelioma of the breast. An immunohistochemical study by light and electron microscopy

Myoepitheliomas of the breast are extremely rare; only four cases have been reported to date. It is not clear whether these tumors behave in a benign or malignant fashion, and no metastatic spread has been documented. We report a myoepithelioma of the breast with metastatic spread to an axillary lymph node. Myoepithelial cell (MEC) differentiation in the tumor was characterized using electron microscopic (EM) criteria. Immunologic investigations at the LM and EM levels showed that the tumor cells were positive for S100 protein, actin, and epidermal cytokeratin; these findings are indicative of MEC differentiation. By immuno-EM, cytokeratin filaments were present in a perinuclear location, while actin filaments were concentrated along the cell periphery. To the authors' knowledge, this is the first report of a breast myoepithelioma that has metastasized and also the first report of the immunologic characterization of a myoepithelioma at the light and electron microscopic levels.