PATHOGENESIS OF PRIMARY CENTRAL-NERVOUS-SYSTEM LYMPHOMA - INVASION OF MALIGNANT LYMPHOID-CELLS INTO AND WITHIN THE BRAIN PARENCHYME
PATHOGENESIS OF PRIMARY CENTRAL-NERVOUS-SYSTEM LYMPHOMA - INVASION OF MALIGNANT LYMPHOID-CELLS INTO AND WITHIN THE BRAIN PARENCHYME
复制标题
DOI：
10.1007/bf00454901
复制
发表时间：
1993-06-01
影响因子：
12.7
通讯作者：
KALIMO, H
中科院分区：
文献类型：
--
作者：
AHO, R;EKFORS, T;KALIMO, H
本文分析了19例原发性中枢神经系统淋巴瘤（PCNSL）和6例脑内转移性淋巴瘤中恶性淋巴细胞的浸润模式，以及4例脑炎和3例星形细胞瘤中反应性淋巴细胞的浸润模式。在原发性和转移性淋巴瘤中相同的扩散模式表明，即使在所谓的原发性CNSL中，恶性转化也发生在CNS之外。恶性淋巴细胞和反应性淋巴细胞的紧密血管周围袖口从来没有看到周围最小的毛细血管，它们是最常见的直径大于15微米的血管周围。血管周围淋巴细胞位于网状蛋白网络内，其对III型和IV型胶原蛋白、层粘连蛋白和纤连蛋白呈免疫阳性。这些发现意味着淋巴细胞在小动脉和小静脉水平外渗，并沿着扩大的血管周围空间扩散。当血管周围网络的外边界被打破，恶性淋巴细胞扩散到中枢神经系统实质，这是不同于其他中枢神经系统转移的模式。归巢细胞粘附分子CD 44在CNS血管和实质中，特别是在PCNSL的好发部位的白色物质中的广泛免疫阳性，表明该粘附分子及其配体参与了CNS实质内恶性淋巴细胞的扩散。
The pattern of invasion of lymphoid cells to the central nervous system (CNS) was analyzed for malignant lymphocytes in 19 primary CNS lymphomas (PCNSL) and six intracerebral metastatic lymphomas, and for reactive lymphocytes in four encephalitides and three astrocytomas. The identical spreading pattern in both primary and metastatic lymphomas suggests that even in the so-called primary CNSL the malignant transformation has occurred outside the CNS. The compact perivascular cuffs of both malignant and reactive lymphocytes were never seen around the smallest capillaries, and they were most common around vessels larger than 15 mum in diameter. Perivascular lymphocytes resided within the reticulin network, which was immunopositive for collagen type III and IV, laminin and fibronectin. These findings imply that lymphocytes extravasate at the level of arterioles and venules and spread along the enlarged perivascular space. When the outer boundary of the perivascular network was broken, malignant lymphocytes spread diffusely into the CNS parenchyme; a pattern which is different from that of other CNS metastases. The widespread immunopositivity for the homing cell adhesion molecule CD44 in the CNS vessels and parenchyme, especially in the white matter which is the predilection site of PCNSL, suggest that this adhesion molecule and its ligands participate in spreading of malignant lymphocytes within the CNS parenchyme.