结节型淋巴细胞为主型霍奇金病临床病理分析

目的探讨结节型淋巴细胞为主型霍奇金病临床病理特征。方法结节型淋巴细胞为主型霍奇金病淋巴结石蜡包埋组织１１例，冰冻组织１例。除ＨＥ切片外，还用抗ＣＤ３，ＣＤ１９，ＣＤ２０，ＣＤ３０，ＣＤ４５ＲＢ及κ、λ单克隆抗体进行ＡＢＣ法免疫组织化学标记，１例冰冻组织采用从组织切片上提取单个细胞行聚合酶链反应（ＰＣＲ）。结果肿瘤组织以结节状排列的小淋巴细胞和组织细胞为背景，其间散在分布Ｌ＆Ｈ细胞。Ｌ＆Ｈ细胞表达ＣＤ１９（１０例），ＣＤ２０（１２例），ＣＤ４５ＲＢ（１２例）及κ轻链（１１例），１例冰冻组织的单个Ｌ＆Ｈ细胞出现ＩｇＨ和Ｖκ４家族基因的重排。８例患者随访期超过５年以上。结论结节型淋巴细胞为主型霍奇金病临床过程非常缓慢，预后良好，其实质是一种特殊的Ｂ细胞肿瘤。

A clinicopathological study of nodular lymphocyte predominance Hodgkin's disease

OBJECTIVE: To investigate the clinicopathological characteristics of nodular lymphocyte predominance Hodgkin's disease. METHODS: Eleven samples of paraffin embedded lymph node and one of frozen lymph node from nodular lymphocyte predominance Hodgkin's disease patients were studied. HE staining, immunohistochemistry for CD3, CD19, CD20, CD30, CD45RB, kappa and lambda light chain and single L&H cell polymerase chain reaction (PCR) were performed. RESULTS: The diagnosis of nodular lymphocyte predominance Hodgkin's disease was established by the identification of characteristic L&H cells in the nodular small lymphocytes and histiocytes background. L&H cells expressed CD19(10/12), CD20(12/12), CD45RB(12/12) and kappa light chain (11/12). IgH and V kappa 4 family gene rearrangements were detected in the single L&H cell. Eight of the patients survived more than 5 years. CONCLUSION: Nodular lymphocyte predominance Hodgkin's disease has a very slow disease course and a better prognosis. It is a malignant lymphoma derived from B cells.