Cytological and functional criteria for the classification of malignant lymphomata.
Cytological and functional criteria for the classification of malignant lymphomata.
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恶性淋巴瘤分类的细胞学和功能标准。
DOI：
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发表时间：
1975
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通讯作者：
E. Kaiserling
中科院分区：
文献类型：
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作者：
K. Lennert;H. Stein;E. Kaiserling
细胞的微妙形态和功能特性是用于定义细胞的最佳参数。对于相应的肿瘤，尤其是恶性淋巴瘤也是如此。因此，在 106 例恶性淋巴瘤的研究中，我们应用血液学染色（切片和印迹中的吉姆萨染色）和电子显微镜分析作为形态学方法。作为功能标准，我们使用非特异性酯酶反应来定义组织细胞肿瘤，并使用组织提取物和单细胞的免疫球蛋白含量估计来定义 B 淋巴细胞及其衍生物的肿瘤。通过结合所有这些方法，可以提出新的分类。尽管在该系列中没有发现一例组织细胞恶性淋巴瘤（“网状肉瘤”），但至少大多数研究的恶性淋巴瘤似乎源自 B 淋巴细胞系统。分为以下类型： (1)慢性淋巴细胞白血病； (2)弥漫性生殖细胞瘤(恶性淋巴瘤、淋巴细胞性、中间型)； (3) 生殖母细胞瘤（滤泡性、滤泡性和弥漫性、弥漫性、硬化性、非硬化性），可显示转变为生殖母细胞肉瘤； (4) B细胞型免疫母细胞肉瘤（以前称为网状肉瘤）； (5)淋巴浆细胞样免疫细胞瘤，可能与华氏巨球蛋白血症有关，并可表现出混合细胞结构； （6）淋巴母细胞（副白细胞）肉瘤和白血病，至少在大多数情况下，可能是生殖母细胞的肿瘤。所有这些淋巴瘤都可以产生免疫球蛋白。 67 例病例显示肿瘤中 Ig 增加。这主要是 IgM，但有时是 IgG、IgA、IgD 和/或 IgE。甚至异常 Ig 分泌的形态学等同物是石蜡切片中淋巴细胞（而不是组织细胞）中的球状阳性（淀粉酶抗性）PAS 反应，我们在 43 例病例中发现了这种反应。 63例肿瘤IgM升高的病例中，只有19例显示血清中IgM升高。华氏巨球蛋白血症是形态不同的恶性淋巴瘤的一种兼性症状，因此应仅被视为一种临床综合征，而不是一个疾病学实体。
The subtle morphology and functional properties of cells are the best parameters to use for their definition. This is also true for the corresponding tumours, especially malignant lymphomata. In studies of 106 cases of malignant lymphoma we therefore applied as morphological methods haematological staining (Giemsa in sections and imprints) and electron microscopic analysis. As functional criteria we used the nonspecific esterase reaction to define tumours of histiocytes and an estimation of the immunoglobulin content of tissue extracts and single cells to define tumours of B lymphocytes and their derivatives. By combining all of these methods it was possible to propose a new classification. Whereas not one histiocytic malignant lymphoma ("reticulosarcoma") was found in the series, at least most of the malignant lymphomata investigated seemed to be derived from the B lymphocyte system. The following types are distinguished: (1) Chronic lymphocytic leukaemia; (2) diffuse germinocytoma (malignant lymphoma, lymphocytic, intermediate); (3) germinoblastoma (follicular, follicular and diffuse, diffuse; sclerotic, nonsclerotic) which can show a transition into germinoblastic sarcoma; (4) immunoblastic sarcoma of the B cell type (previously called reticulo-sarcoma); (5) lymphoplasmocytoid immunocytoma, which may be associated with Waldenstrom's macroglobulinaemia and can show a mixed cellularity; (6) lymphoblastic (paraleukoblastic) sarcoma and leukaemia, which are, at least in most cases, probably neoplasias of germinoblasts. All of these lymphomata can produce immunoglobulins. Sixty-seven cases showed an Ig increase in the tumour. This was mostly IgM, but sometimes IgG, IgA, IgD and/or IgE. A morphological equivalent of even abnormal Ig secretion is the globular positive (diastase resistant) PAS reaction in lymphoid cells (not in the histiocytes) in paraffin sections, which we found in 43 cases. Only 19 of the 63 cases with an IgM increase in the tumour showed an increase of IgM in the serum. Waldenström's macroglobulinaemia is a facultative symptom of morphologically different malignant lymphomata and should therefore be considered only as a clinical syndrome and not as a nosological entity.