PDF(Pubmed)
Abstract：
Tissue eosinophilia is seldom reported in B-cell lymphoma. It poses diagnostic challenges and frequently leads to the consideration of other diagnoses, particularly T-cell lymphomas. The scarce literature underscores the need for in-depth studies to enhance awareness and understanding of this phenomenon. We investigated 54 cases of B-cell lymphoma with notable tissue eosinophils, analyzing clinical information, hematoxylin and eosin staining, immunohistochemistry, and PCR-based clonality analysis. Nodal marginal zone lymphoma (NMZL) emerged as the most prevalent type (n=26), followed by B-cell lymphoma, not otherwise specified (n=13), diffuse large B-cell lymphoma (n=10), follicular lymphoma (n=2), chronic lymphocytic leukemia/small lymphocytic lymphoma (n=1), extranodal marginal zone lymphoma (n=1), and primary cutaneous marginal zone lymphoma (n=1). Shared features across different lymphoma types, best exemplified by NMZL, included plasmacytic differentiation (57.7%), increased vascularity (84.6%) with a tendency for perivascular distribution of neoplastic cells, and a tumor microenvironment abundant in T cells and histiocytes; some cases showed increased PD-1-positive cells. These features often raise consideration of angioimmunoblastic T-cell lymphoma. Along with clonality analysis, features supporting the diagnosis of B-cell lymphoma included cytological atypia in B cells rather than T cells, and the lack of follicular dendritic cell meshwork expansion. In addition, diffuse large B-cell lymphoma frequently exhibited interfollicular distribution and monocytoid appearance, indicating the possibility of transformed NMZL. Collectively, tissue eosinophilia can occur in diverse B-cell lymphomas but is most prevalent in tumors with a postgerminal stage of differentiation.
摘要：
组织嗜酸性粒细胞增多在B细胞淋巴瘤中很少报道。它提出了诊断挑战，并经常导致考虑其他诊断，特别是T细胞淋巴瘤.稀缺的文献强调需要进行深入研究，以增强对这一现象的认识和理解。我们调查了54例B细胞淋巴瘤，并伴有明显的组织嗜酸性粒细胞，分析临床信息，苏木精和伊红染色，免疫组织化学，和基于PCR的克隆性分析。淋巴结边缘区淋巴瘤（NMZL）是最常见的类型（n=26），其次是B细胞淋巴瘤,未指定（n=13），弥漫性大B细胞淋巴瘤（n=10），滤泡性淋巴瘤（n=2），慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（n=1），结外边缘区淋巴瘤（n=1），原发性皮肤边缘区淋巴瘤（n=1）。不同淋巴瘤类型的共同特征，最好的例子是NMZL，包括浆细胞分化（57.7％），血管分布增加（84.6％），肿瘤细胞在血管周围分布的趋势，以及T细胞和组织细胞中丰富的肿瘤微环境；一些病例显示PD-1阳性细胞增加。这些特征通常会引起对血管免疫母细胞性T细胞淋巴瘤的考虑。随着克隆分析，支持B细胞淋巴瘤诊断的特征包括B细胞而不是T细胞的细胞学异型，和缺乏滤泡树突状细胞网的扩增。此外,弥漫性大B细胞淋巴瘤经常表现为滤泡间分布和单核细胞样外观，表明转化的NMZL的可能性。总的来说，组织嗜酸性粒细胞增多可发生在多种B细胞淋巴瘤中，但在分化为生发后阶段的肿瘤中最为普遍。
