消化管原発悪性リンパ腫の病理組織学的および免疫組織学的研究

抄録

A total of 36 cases with gastrointestinal malignant lymphomas, consisting of 22 of stomach, 8 of small intestine, 3 of large intestine and 3 of multiple occurrence through the gut, were studied to characterize growth pattern, cytologic features and histogenesis by the use of histologic and immunohistochemical techniques.
Phenotypically 33 cases were of B cell type and 3 of T cell type.
Cases with high grade malignancy according to working formulation showed deeper invasion in the gut wall comparing to those of lower malignancy.
According to LSG classification, 6 cases were of follicular and other 27 cases were of diffuse lymphoma in B cell type.
Histologically diffuse large cell lymphoma was the most preponderant type as high as 31%.
Immunohistochemical features of mantle zone lymphocytes with sIgM⁺, sIgD⁺, Leu-1⁺, Leu-8⁺ and ALPase⁺ were different from those of germinal centers with sIgM⁺ and CALLA⁺. Based on these findings, a histogenesis of primary B cell gastrointestinal lymphoma was histologically and phenotypically divided into three origins, pre-follicle center cell origin (mantle zone lymphocyte origin), follicle center cell origin and postfollicle center cell origin. Medium-sized lymphomas derived from mantle zone lymphocytes may have close similarity to those of mucosa-associated lymphoid tissue (MALT) lymphomas proposed by Isaacson et al.