Summary
Eighteen cases of low grade malignant B-cell lymphomas (confirmed through enzyme cytochemistry and immunocytology) were investigated morphologically using thin and semithin sections. Four types with a characteristic pattern of different lymphoid cells were found: (1) the lymphocytic type, predominantly consisting of small lymphocytes; (2) the lymphocytoid (centrocytic or prolymphocytic) type, in which in addition to small lymphocytes medium-sized lymphocytes (with or without cleaved nuclei) are found; (3) the lymphoplasmacytoid type, where lymphoid cells with different degrees of similarity to plasma cells are seen as well as small and medium-sized lymphocytes; and (4) the centroblastic-centrocytic type, in which centroblasts are present next to small and medium-sized lymphocytes.
These findings correlate well with the morphological observations in low-grade malignant B-cell lymphomas of the lymph nodes. Therefore, the application of modern classifications of non-Hodgkin lymphomas, such as the “Kiel Classification”, to cutaneous lymphomas appears justified. Thin and semithin sections are particularly useful in suspected cases of cutaneous malignant lymphoma, in which paraffin sections did not allow the diagnosis to be established.
Zusammenfassung
Achtzehn Fälle von cutanen B-Zell Lymphomen von niedrigem Malignitätsgrad (gesichert durch Enzymcytochemie und Immuncytologie) wurden morphologisch mittels Semidünn- und Dünnschnitten unter-sucht. Vier Typen mit einem charakteristischen Muster von verschiedenen lymphoiden Zellen wurden gefunden: (1) Der lymphocytische Typ, überwiegend aus kleinen Lymphocyten bestehend; (2) der lymphocytoide (zentrocytische oder prolymphocytische) Typ, bei dem neben kleinen auch mittelgroße Lymphocyten (mit und ohne geknitterten Zellkernen) erscheinen; (3) der lymphoplasmacytoide Typ, bei dem neben kleinen und mittelgroßen Lymphocyten lymphoide Zellen mit unterschiedlich ausgeprägten Differenzierungsmerkmalen von Plasmazellen zu finden sind; sowie (4) der zentroblastische-zentrocytische Typ. Hier sind neben kleinen und mittelgroßen Lymphocyten auch Zentroblasten zu beobachten.
Insgesamt stimmen die hier erhobenen morphologischen Befunde gut mit entsprechenden nodalen malignen Lymphomen überein. Die Anwendung moderner Klassifikationen von non-Hodgkin Lymphomen, insbesondere die »Kiel-Klassifikation«, erscheint daher auch für die Hautlymphome gerechtfertigt. Dünn- und Semidünnschnitte eignen sich bei der Routinediagnostik von derartigen Krankheitsfällen, vor allem dann, wenn mit Paraffinschnitten keine klare diagnostische Einordnung erfolgen konnte.
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Supported by the Deutsche Forschungsgemeinschaft
The technical assistance of Ms. V. Kügler is gratefully acknowledged.
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Schmoeckel, C., Burg, G. & Braun-Falco, O. Quantitative analysis of lymphoid cells in cutaneous low-grade malignant B-cell lymphomas. Arch Dermatol Res 266, 239–251 (1979). https://doi.org/10.1007/BF00418570
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DOI: https://doi.org/10.1007/BF00418570