Midline malignant reticulosis (MMR) and peripheral T-cell lymphoma--a clinicopathologic study of 78 cases

Seventy-eight cases of MMR selected from 141 cases of so-called malignant granulomatosis (MG) in our hospital during the past 27 years (1960-1986) are reported. All were treated mainly by radiotherapy, and 50 cases had been followed for long period. The overall 5-year survival rate was 44%. Although most of the patients died within 2 years, two had survived for more than 20 years after treatment. The microscopic features of these lesions were consistent with the peripheral T-cell lymphomas (PTL), which occur in other organs or sites as well. It could be roughly divided into two groups: monomorphic and polymorphic. Monomorphic lesions could be subdivided into several types again, such as large cell, mixed cell, clear cell, intermediate round cell types, and so on. In these cases, 11 were assayed for immunophenotype, including kappa, lambda and ACT, showing that the tumor cells were negative. Furthermore, 3 other new cases were stained with B1, IgM, Kappa, lambda, and/or Leu-2, Leu-3, Leu-4. Two of them were positive for Leu-3+, Leu-4+ and one for Leu-2+, Leu-3+, Leu-4+. All the results conform well to the diagnostic criteria of PTL as agreed upon by some Chinese and foreign authors. That means most of the MMR may be a group of heterogeneous extranodal PTL, and should be treated as T-cell lymphomas.