Splenic lymphoproliferative disorders in human T lymphotropic virus type-I endemic area of japan: clinicopathological, immunohistochemical and genetic analysis of 27 cases

Primary splenic involvement in lymphoid neoplasms is rare and the clinicopathologic features of splenic lymphoma are not well described compared to nodal non-Hodgkin's lymphoma (NHL). Here we characterized splenic lymphomas in an human T lymphotropic virus type-I (HTLV-I) endemic area of Japan. To assess the pattern of splenic involvement and evaluate prognosis, we reviewed 27 specimens consisting of 26 splenectomies and one necropsy, which were classified using REAL classification. Cases were divided into primary splenic lymphoma in 11 patients and secondary in 16 patients. The incidence of primary splenic lymphoma was 0.3% (11 of approximately 4,000 malignant lymphomas). Primary splenic lymphomas included 7 diffuse large B cell lymphoma (DLBL), 2 follicular lymphomas (FL), and 1 each of splenic marginal zone lymphoma (SMZL) and anaplastic large cell lymphoma (ALCL). Secondary splenic lymphomas included 6 DLBL, 4 mantle cell lymphoma (MCL), 2 FL, 2 Hodgkin's disease (HD), 1 each of hairy cell leukemia and ALCL. Gross examination showed two patterns of splenic involvement; solid type (formation of large nodular mass, n=16) and disseminated type (multiple nodules with diffuse infiltration but no large nodular formation, n=10). The type could not be determined in one case. Most solid types were DLBL or FL, while MCL was of the disseminated type. Immunohistochemistry showed all but each 2 cases of ALCL and HD were of B lineage. Follow-up of 26 patients indicated that all but one patient with primary lymphoma were still alive (range, 1-89 months) and 8 of 15 patients with secondary lymphomas died due to the progression of malignant lymphoma; the survival rate at 2 years was 50% in these patients. No elevation of anti-HTLV-I antibody was found. In situ hybridization for Epstein-Barr virus (EBV) showed no reactivity of lymphoma cells, although a few small lymphocytes were positive for EBV. Hepatitis C virus was observed in 6 of 20 (30%) patients examined and 4 of 11 (36%) cases of primary splenic lymphoma. Our findings indicate that patients with primary splenic lymphoma have a favorable prognosis after splenectomy.     

Splenic Lymphoproliferative Disorders in Human T Lymphotropic Virus Type-I Endemic Area of Japan: Clinicopathological, Immunohistochemical and Genetic Analysis of 27 Cases

Primary splenic involvement in lymphoid neoplasms is rare and the clinicopathologic features of splenic lymphoma are not well described compared to nodal non-Hodgkin's lymphoma (NHL). Here we characterized splenic lymphomas in an human T lymphotropic virus type-I (HTLV-I) endemic area of Japan. To assess the pattern of splenic involvement and evaluate prognosis, we reviewed 27 specimens consisting of 26 splenectomies and one necropsy, which were classified using REAL classification. Cases were divided into primary splenic lymphoma in 11 patients and secondary in 16 patients. The incidence of primary splenic lymphoma was 0.3% (11 of approximately 4,000 malignant lymphomas). Primary splenic lymphomas included 7 diffuse large B cell lymphoma (DLBL), 2 follicular lymphomas (FL), and 1 each of splenic marginal zone lymphoma (SMZL) and anaplastic large cell lymphoma (ALCL). Secondary splenic lymphomas included 6 DLBL, 4 mantle cell lymphoma (MCL), 2 FL, 2 Hodgkin's disease (HD), 1 each of hairy cell leukemia and ALCL. Gross examination showed two patterns of splenic involvement; solid type (formation of large nodular mass, n = 16) and disseminated type (multiple nodules with diffuse infiltration but no large nodular formation, n = 10). The type could not be determined in one case. Most solid types were DLBL or FL, while MCL was of the disseminated type. Immunohistochemistry showed all but each 2 cases of ALCL and HD were of B lineage. Follow-up of 26 patients indicated that all but one patient with primary lymphoma were still alive (range, 1-89 months) and 8 of 15 patients with secondary lymphomas died due to the progression of malignant lymphoma; the survival rate at 2 years was 50% in these patients. No elevation of anti-HTLV-I antibody was found. In situ hybridization for Epstein-Barr virus (EBV) showed no reactivity of lymphoma cells, although a few small lymphocytes were positive for EBV. Hepatitis C virus was observed in 6 of 20 (30%) patients examined and 4 of 11 (36%) cases of primary splenic lymphoma. Our findings indicate that patients with primary splenic lymphoma have a favorable prognosis after splenectomy.     

Primary splenic presentation of malignant lymphoma and related disorders. A study of 49 cases

The diagnosis of malignant lymphoma presenting as an initial splenic manifestation may go unrecognized as such when peripheral lymph nodes are not enlarged and when results of bone marrow biopsies are negative. Tissues from 49 patients, ranging in age from 15 to 78 years, in whom the original diagnosis of malignant lymphoma and related conditions was made at splenectomy, were classified as: diffuse small lymphocytic (20), diffuse large cell (11), diffuse small cleaved (5), diffuse large cell, immunoblastic (5), follicular small cleaved cell (3), and follicular mixed small cell and large cell (2). Two additional spleens, diagnosed as acute blastic leukemia, were initially confused with malignant non-Hodgkin's lymphoma by light microscopy. One patient presented with Hodgkin's disease confined to the spleen. For the non-Hodgkin's lymphoma group, parameters of age, sex, splenic weight (range, 226-4000 g), lymph node, bone marrow, or liver involvement did not adversely influence prognosis. Abdominal lymph nodes were positive in 31 of 37 patients having splenic hilar and/or abdominal lymph nodes available for review. Of 29 patients with adequate follow-up, 7 died of disease, 5 were free of disease at 3 years, 2 were free of disease at 5 years, 2 were alive with disease at 3 years, 4 were alive with disease at 5 years, and 9 died from second malignancies, unknown, or unrelated causes. Six of the 7 patients who died of lymphoma were classified as large cell (four diffuse large cell and two diffuse large cell, immunoblastic), with a mean 2-year survival. One patient died of leukemia. Those lymphomas classified as low grade behaved in an indolent fashion. The morphologic diversity of these cases emphasizes the need for the initial recognition and correct classification of lymphomas which present in the spleen, since survival is best determined according to histologic type.     

Nucleolar organizing regions in primary intracranial malignant lymphomas

Twenty-two non-immunocompromised patients with primary intracranialmalignant lymphomas were examined on surgical material by using anargyrophilic method for the demonstration of nucleolar organizer regions asAg-NORs. The histopathological classifications of 22 patients included 3small lymphocytic, 7 small cleaved, 9 large cell, 1 mixed large and small,and 2 small non-cleaved type. The numbers of Ag-NOR of malignant lymphomapatients varied from 1.36 to 5.02 (mean 3.46 ± 0.25). The mean Ag-NORnumbers in the histopathological subtypes were small lymphocytic 1.63, smallcleaved 3.18, large 4.21, mixed large and small 3.47, and small non-cleaved3.78. The number of Ag-NORs in small lymphocytic type was significantly lessthan small cleaved or large cell type (p < 0.05). The small cleaved typealso had a smaller Ag-NOR number than the large cell type (p < 0.05).Except for two patients who had postoperative deterioration, 20 patientsreceived postoperative irradiation ranging from 36 to 54 Gy (median, 46 Gy).Sixteen patients had complete response to radiotherapy, and 4 had goodpartial response. Ten patients had tumor recurrence within the remissionperiod of 3 months to 7 years and 10 months (median 4.8 months). Threepatients with intracranial relapse at a remote site had a significantlylonger remission period (mean 57.3 months) than 7 with local relapse (mean6.29 months), p < 0.05. The mean Ag–NOR number of the short andlong remission period were 3.13 ± 0.34 and 3.81 ± 0.80,respectively. No significant difference was found between these two groups.The survival period was 3.2 months to 12 years (median 20 months). TheAg-NOR numbers of survival period less than or more than 20 months were 3.62± 0.40 and 3.27 ± 0.37, respectively. The Ag-NOR numbers didnot correlate with either the remission or the survival period. Theseresults indicate that Ag-NOR numbers may correlate with the histopathologictypes, but not with the prognosis of primary intracranial malignantlymphomas.     

Malignant lymphoma of the skin in children

The clinical and histopathologic findings in eight cases of malignant lymphoma of the skin in children are presented. All patients had skin lesions as a primary manifestation of the disorder. Three patients had simultaneous regional lymph node involvement documented by the findings of subsequent biopsies. The majority (five patients) had solitary nodules involving the skin of the head and neck region. Three of the skin biopsy specimens were classified as lymphoblastic lymphoma, two large cell lymphoma, two mixed small and large cell lymphoma, and one small cleaved cell lymphoma. Disseminated disease subsequently developed in four patients in an interval that ranged from 4 to 30 months after diagnosis. The follow-up period ranged from 8 to 56 months, and median survival was 56 months. A literature review of 33 previously reported patients and our eight patients indicate that: skin of the head and the neck region is the most common site of involvement (56%); the majority of lymphomas are diffuse (93%); lymphoblastic lymphoma is the predominant type (53%), with a high proportion showing a non-T-cell phenotype; Burkitt's lymphoma and Hodgkin's disease of the skin are extremely rare; and most patients presented in an early clinical stage (Stage IE 56%, Stage IIE 21%), and prolonged disease-free survival was seen mostly in Stage I patients. The cumulative probability of survival for Stage I patients at 24 months was 0.71; while for Stages II to IV patients combined, it was 0.33 at 26 months.     

Follicular mantle zone cell subpopulations detected by monoclonal antibody SN3

A monoclonal antibody, SN3, has been prepared against a cell membrane fraction of the pre-B leukemic cell line NALM-1. By radioimmunoassay, SN3 reacted with four of four non-T/non-B, two of two pre-B and one of three leukemic B cell lines. The reagent was unreactive, however, with established leukemic T and myelomonocytic cell lines or normal B cell lines. On immunohistochemical assays on frozen sections of nine reactive lymph nodes and three spleens, SN3 showed a preferential binding to 50-95 per cent mantle zone (MZ) cells and 5-20 per cent interfollicular or red pulp B-lymphocytes. This was uninhibited by pre-incubation with heterologous anti-HLA-DR or anti-delta reagents. SN3 was unreactive with normal germinal centre (GC), epidermal or Langerhans cells but did react with less than 1 per cent thymic B-lymphocytes. In eight follicular small cleaved cell lymphomas tested SN3 exhibited three patterns of reactivity: peripheral follicular, combined peripheral and central follicular, and combined follicular and interfollicular. Three follicular lymphomas were essentially SN3-. In three diffuse small lymphocytic lymphomas, SN3 showed patchy areas of reactivity unassociated with proliferation centres. In four diffuse B-cell lymphomas (one mixed small and large cell, two large non-cleaved cell, and one small non-cleaved (Burkitt) cell), SN3 reactivity was uniformly distributed in the majority (60-90 per cent) of the cells. SN3 was unreactive with one diffuse B-large cell lymphoma, three nodal T-cell lymphomas and three cases of mycosis fungoides. The findings indicate that SN3 detects an antigen that is present in subpopulations of normal MZ cells, the antigen is also detected in GC cells undergoing lymphomatous transformation but is not readily detected in normal GC cells, and the antigen is also expressed in subpopulations of diffuse B- but not T-cell lymphomas.     

膀胱原发恶性淋巴瘤的临床病理特点、免疫表型和预后

目的　探讨膀胱原发恶性淋巴瘤的临床、病理组织学特点和免疫表型。方法　回顾性总结 7例膀胱恶性淋巴瘤的临床和病理组织学资料 ,免疫组织化学染色确定免疫表型。结果　 6例原发性 ,1例继发性。 7例均为老年患者 ,女性 5例 ,男性 2例 ;6例原发性结外MALT型边缘区B细胞淋巴瘤 4例 ,弥漫性大B细胞淋巴瘤 2例 ,1例继发是弥漫性大B细胞淋巴瘤。结论　膀胱恶性淋巴瘤好发于 60岁左右的老年人 ,常见的临床表现是血尿和膀胱肿块。常见病理类型是弥漫性大B细胞淋巴瘤和结外MALT型边缘区B细胞淋巴瘤。     

卵巢原发性非何杰金氏恶性淋巴瘤

Five cases of primary non-Hodgkin's lymphoma of the ovary (OPNHL) are reported. All were B cell lymphomas (1 small cleaved, 2 non-cleaved and 2 cleaved non-cleaved lymphoma) and treated with operation combined with chemotherapy, 2 of whom also received radiotherapy. One case died 15 months after operation, 4 are still alive, and 2 of these 4 have survived for over 3 years. The clinical manifestations of OPNHL are similar to those of ovarian carcinoma, therefore, it is difficult to diagnose this disease before operation. Histologically, it is important to differentiate OPNHL from granulosa cell tumor and dysgerminoma. Debulking operation should be attempted and timely chemotherapy and/or radiotherapy given for better results even for advanced ovarian lymphoma.     

Non-Hodgkin's lymphoma in bone. Pathologic and radiologic features with clinical correlates

Thirty-seven lymphomas of bone were studied, including 33 diffuse large cell lymphomas, three undifferentiated (small noncleaved cell) lymphomas, and one well-differentiated (small) lymphocytic lymphoma. The large cell lymphomas were subclassified as large cleaved, large noncleaved, multilobated cell, and immunoblastic sarcoma (large cell lymphoma, immunoblastic type). Eleven of 26 large cell lymphoma patients with adequate follow-up were long-term survivors (free of disease for more than 5 years). Nineteen of the 33 large cell lymphomas were localized to one bone. The stage and histologic pattern significantly correlated with long-term survival among large cell lymphomas. Seventy-three percent of patients with localized lymphoma were long-term survivors, in contrast to 9% of those with disseminated disease. Sixty-seven percent of patients with large cleaved and multilobated cell lymphoma were long-term survivors, but only 21% of those with large noncleaved cell and immunoblastic sarcoma were. The tumors had a blastic, lytic, or mixed radiographic appearance and had either sclerotic, lytic, or permeative borders; none of the radiologic findings were diagnostically useful.     

原发性前列腺恶性淋巴瘤11例诊治报道

目的:探讨原发性前列腺恶性淋巴瘤(Primary Malignant lymphoma of the prostate, PMLP)的临床诊治特征及预后。方法:收集中山大学附属第三医院、中山大学附属第一医院、平顶山学院附属医院2005年11月至2016年12月共11例PMLP患者的临床资料、诊疗及预后信息。结果: 11例患者发病年龄57～82岁,中位年龄68岁。血清前列腺特异性抗原（Prostate-Specific antigen,PSA）平均2.68ng/ml(0.54～4.82ng/ml),血清乳酸脱氢酶（LDH）平均值为314.9（123～560）U/L。CT检查均提示前列腺明显增大,临床下尿路梗阻症状明显。组织病理学符合B细胞源性非霍奇金淋巴瘤,其中弥漫大B淋巴瘤9例,套细胞淋巴瘤2例。中位生存期28个月(9～62月),6例已死亡。10例选择手术治疗,6例术后进一步接受CHOP或R-CHOP化疗,其中3例生存期已超过56个月。结论:PMLP罕见,预后与病理组织学分类、临床分期及治疗方案紧密相关。实验室检查（PSA、LDH）、CT检查特异性不明显。PMLP化疗效果明显,手术可有效缓解下尿路梗阻症状,必要时可联合治疗。     

Histogenesis of diffuse small cleaved cell lymphoma. An immunohistochemical and molecular genetic (bcl-2 gene) study with comparison to follicular small cleaved cell lymphoma and mantle zone lymphoma.

Immunohistochemical and molecular genetic (bcl-2 gene) studies were performed on specimens from 24 patients with follicular small cleaved cell lymphoma (FSCCL), 24 patients with diffuse small cleaved cell lymphoma (DSCCL) and 4 patients with mantle zone lymphoma (MZL) to determine the cellular origin of the disease and whether or not DSCCL represents the diffuse counterpart of FSCCL. Two patients with FSCCL, 22 patients with DSCCL, and all of the patients with MZL had a phenotype of mantle zone (MZ) B-lymphocytes (SIgD+, Leu-1+, Leu-8+, positive alkaline phosphatase [ALPase+], and negative common acute lymphoblastic leukemia antigen [CALLA-]), and all the tested patients (2 patients with FSCCL, 13 patients with DSCCL, and 4 patients with MZL) had germlines of bcl-2 gene. Fourteen patients with FSCCL and 1 patient with DSCCL had a phenotype of follicular center cells (FCC) (CALLA+, SIgD-, Leu-1-, Leu-8- and negative ALPase), and 11 patients with FSCCL had bcl-2 gene rearrangements. These results indicate that FSCCL are almost always derived from FCC, whereas some FSCCL, most DSCCL, and all MZL are derived from MZ B-lymphocytes, and these lymphomas should be included in the same category as MZ B-lymphocyte-derived lymphomas. Histologically diagnosed DSCCL often may represent a diffuse counterpart of MZ B-lymphocyte-derived lymphoma. MZ B-lymphocyte-derived lymphomas histologically show a follicular (nodular), a follicular MZ, or a diffuse growth pattern and clinically show a high incidence of peripheral blood (PB) involvement or bone marrow (BM) involvement.     

Bcl-1 gene rearrangements in B cell lymphoma

We analyzed 50 B cell lymphoma samples by Southern blot analysis, using the bcl-1 and heavy chain immunoglobulin (JH) probes with two or more restriction endonucleases. All samples showed JH rearrangement, and three samples (two diffuse small lymphocytic lymphomas and one diffuse large cell lymphoma probably transformed from a diffuse small lymphocytic lymphoma) demonstrated rearranged bcl-1 sequences. The three samples showed the t(11;14)(q13;q32) chromosome translocation, and all three contained rearranged JH fragments that comigrated with the rearranged bcl-1 fragment. The breakpoint of the translocation occurred within a 1.6-kb region on chromosome 11 in the three cases. Two of the three patients had primary refractory disease. Two of the three patients had gastrointestinal involvement. Bcl-1 rearrangement may identify an unusual subset of patients with primary refractory disease with gastrointestinal involvement. It may also describe a unique subset of large cell lymphoma patients transformed from diffuse small cell histology.     

Malignant lymphoma and granulocytic sarcoma of the uterus and vagina. A clinicopathologic analysis of 27 cases

Twenty-five cases of malignant lymphoma of the uterine corpus or cervix and the vagina, and one case of granulocytic sarcoma of the cervix were analyzed. The patients typically presented with vaginal bleeding and a subepithelial mass without obvious ulceration or other epithelial abnormality. Twenty-one of the 27 tumors appeared to originate in the cervix, 4 in the vagina, and 2 in the endometrium. Seven of them were nodular lymphomas, 17 diffuse large cell, or "histiocytic" lymphomas, 1 was a Burkitt's tumor, and 2 were granulocytic sarcomas. Sclerosis was a prominent histologic feature in lymphomas of the cervix and vagina. Twenty-one patients had disease confined to a single extranodal site (Ann Arbor Stage IE), and six had lymph node or ovarian involvement (Stages IIE + IV). The overall actuarial 5-year survival was 73%. The survival of patients with Stage IE tumors was 89%, compared with 20% for patients with lymph node or ovarian involvement. None of the 12 patients with Stage IE lymphoma of the cervix or vagina who received definitive initial local treatment (surgical and/or radiation therapy) relapsed. Nodular lymphomas and diffuse lymphomas with a preponderance of large cleaved cells were more often localized and had a better prognosis than large or small noncleaved and immunoblastic types. Lymphoma of the lower female genital tract is a rare, but treatable malignancy, which must be distinguished microscopically from inflammatory lesions and nonlymphoid tumors arising in this site.     

Correlation of surface receptors with histological appearance in 29 cases of non-Hodgkin lymphoma.

The receptor patterns of cell suspensions from 29 cases of non-Hodgkin lymphoma were correlated with the histology of the nodes from which the cells were taken. Twenty-two were judged to be predominantly or largely B-cell, and because of this preponderance these were divided by a method based on the distribution of surface immunoglobulin and the expression of Fc and C3 receptors. "Mature" B-cell and B-mixed tumours showing capping surface Ig with Fc and/or C2 receptors correlated well with a nodular growth pattern, and consisted of what Rappaport (1966) calls "poorly differentiated" lymphocytes equivalent to the "small cleaved" cells as defined by Lukes and Collins (1975). Ten of the 14 patients in this receptor category are alive between 12 and 30 months after diagnosis. Receptor-silent and "immature" B-cell tumours with non-capping surface Ig correlated predominantly with the Rappaport histiocytic lymphoma and Lukes and Collins' large cleaved and large non-cleaved lymphomas, though these histological categories also included a wide variety of other receptor types such as T-cell, Receptor-overlap and the single true Macrophage tumour.Five of the 11 patients with receptor-silent or immature B-cell tumours are alive between 7 and 15 months after the diagnosis. Diffuse mixed and diffuse poorly differentiated lymphocytic lymphomas in Rappaport's classification correlated poorly with receptors, mature and immature B-cell tumours being equally represented.     

Malignant histiocytoses developing in patients with B-cell lymphomas. Report of two cases

Two patients with indolent B-cell lymphomas (small B-cell and small cleaved cell) developed a coexistent malignant histiocytosis 3 and 6 years after diagnosis of their lymphomas. In both patients, malignant histiocytosis presented as new onset of fever, weight loss, and rapidly progressive bulky disease super-imposed on a previously stable clinical course without constitutional symptoms. Both patients failed to respond to combination chemotherapy. The terminal aggressive phase of indolent B-cell lymphomas usually represents transformation of the original neoplasm to a large non-cleaved or immunoblastic B-cell histology. Malignant histiocytosis has not previously been reported as a second neoplasm in patients with B-cell lymphomas.     

Immunologic, Clinicopathologic and Prognostic Features of Lymphoma of the Gastrointestinal Tract

The lymphoma cells of 32 patients with histopathologically provenmalignant lymphomas with gastrointestinal (G-I) tract involvementwere examined for their surface marker characteristics. Twelvecases were diagnosed as primary lymphoma of the G-I tract and20 cases as secondary lymphoma of the G-I tract according toclinical and autopsy findings. Only one of the primary G-I tractlymphomas was identified as T-cell type, seven as B-cell typeand four as surface immunoglobulin (S-Ig)-negative non-T type(defective B-cell type). Ten of the 11 cases of non-T cell typewere histopathologically diagnosed as diffuse large lymphoidlymphoma, and one as diffuse medium-sized or poorly differentiatedlymphocytic lymphoma. This suggests that most primary G-I tractlymphoma would be large lymphoid lymphoma, even if it couldbe found at an early stage. The histopathological diagnosisof one case of T-cell type was controversial lymphocyte depletionof Hodgkin's disease or pleomorphic lymphoma is most probable. Three of the 20 secondary G-I tract lymphomas were identifiedas T-cell type, eight as B-cell type, five as defective B-celltype and four as S-Ig-undetermined non-T cell type. In contrastwith the primary G-I tract lymphomas, all histologic types wereincluded in the secondary G-I tract lymphomas. The period fromonset to G-I tract involvement ranged from four to 88 mo withan average of 32.6 mo. The tumor mass in the G-I tract in B-celllymphoma was usually large enough to be able to be detectedclinically, while a large proportion of the G-I tract lesionsin defective B-cell lymphoma and T-cell lymphoma were so smallthat they were detected only at autopsy. These results suggestthat B-cell lymphoma has a higher incidence of G-I tract involvementand a more pronounced capacity to proliferate in the G-I tractthan defective B-cell lymphoma and T-cell lymphoma. The prognosis for the patients with G-I tract lymphoma variedaccording to the stage at the time of the first examination.All three patients with stage I primary lymphoma of the G-Itract are surviving, while only three of nine patients withstage II or higher are still alive. In the case of secondaryG-I tract lymphoma, although the median survival time of stageI patients was fairly long (66 mo). more than 80% of the patientsdied of the disease. Half of the patients with stage I diseasedied within 6 mo and about 40% of the patients died within 1mo after G-I tract involvement. This indicates that secondaryG-I tract involvement of lynaphoma is a poorer risk factor forprognosis than is primary G-I tract lymphoma.     

Clinical Analysis of 29 Cases with Primary Malignant Lymphoma of the Prostate

OBJECTIVE To summarize the clinical characteristics, pathology, treatment and prognosis of malignant lymphoma of the prostate. METHODS Clinical data from 29 patients with primary malignant lymphoma of the prostate were reviewed retrospectively. The median age was 66 years. Clinical signs and symptoms were due to lower urinary tract obstruction resulting from a diffusely enlarged prostate. Prostate biopsies revealed diffuse large B-cell non-Hodgkin＇s lymphoma. The therapeutic modalities included prostatectomy, radiotherapy and chemotherapy. RESULTS Extraprostatic involvement at various sites became evident in 19 of the 29 patients after diagnosis. Ten patients died from lymphoma with a median survival of 23 months （range, 2-30 months）. Seven patients were alive up to 60 months. CONCLUSION Malignant lymphoma involving the prostate was rare and has a rather poor prognosis. Prognosis related to the patient age, histologic type, and treatment or clinical stage of the disease at presentation.     

100例恶性淋巴瘤的临床分析

目的 观察恶性淋巴瘤患者的骨髓象，了解骨髓侵犯与临床分期、病理、血尿β2－MG、血LDH、外周血象及预后等的关系。方法：对100例恶性淋巴癌患者的骨髓象作分类比较。结果 骨髓侵犯率18％，以Ⅲ、Ⅳ期具有B组症状患者为主；病理以弥漫型小淋巴细胞性、裂－无裂细胞性、无裂细胞性多见。初诊时血尿β2－MG、血LDH升高者、外周血象异常者易发生骨髓侵犯。结论 恶性淋巴瘤患者发生骨髓侵犯者预后不良。     

Prognostic implications of karyotype and morphology in patients with non-Hodgkin's lymphoma

Clonal chromosome abnormalities were observed in 30 patients with non-Hodgkin's lymphoma; the type of lymphoma was characterized on the basis of the International Working Formulation. The 30 patients were classified into five groups according to the chromosome abnormality. There were 8 patients with t(14;18), 3 with t(8;14), 7 with a translocation to the long arm of chromosome 3 (a 3q+ chromosome), 5 with near-tetraploidy, and 7 with other abnormalities. Among the 8 patients with t(14;18), 5 had follicular small cleaved-cell lymphoma (FSC), I had follicular mixed cell lymphoma (FM), and 2 had diffuse large-cell lymphoma (DL); the diagnosis in these 2 patients was based on extranodal tissue. All 3 patients with t(8;14) had DL and B-cell markers. Except for 1 patient, all those with a 3q+ chromosome had DL; 4 of those who were tested had B-cell or pre-B-cell markers. Four of the 5 patients with near-tetraploidy had follicular mixed-cell lymphoma, and 2 of the 7 patients with other abnormalities had T-cell lymphoma. Thus, patients with a t(8;14), a 14q+ chromosome, or a 3q+ chromosome all tend to have diffuse large-cell lymphoma, usually of the non-cleaved type. On the other hand, our data suggest that patients with FSC generally have a t(14;18) whereas those with follicular and diffuse mixed small cleaved cells and large noncleaved cells have a different pattern with modal chromosome numbers in the tetraploid range. We added 17 previously reported patients to the 30 presented here and correlated the karyotype with survival. The 6 patients with near-tetraploidy had the longest median survival, 69 months, the 15 patients with t(14;18) had the next longest, 48 months. The 4 patients with t(8;14) had the shortest survival, 12 months, and the 9 with other abnormalities had the next shortest, 17 months. Intermediate survivals of 27 and 30 months were observed in patients with a 14q+ or a 3q+ chromosome, respectively. The median survival of these various categories differs and our data, thus, indicate that the karyotypic pattern of the malignant cell may be a significant independent prognostic feature influencing the survival of patients with non-Hodgkin's lymphoma.