小児Ｎｏｎ‐Ｈｏｄｇｋｉｎ’ｓ Ｌｙｍｐｈｏｍａ２６例の臨床病理学的検討

Abstract

Twenty six cases diagnosed as Non-Hodgkin's lymphoma in patients under 15 years of age between 1980 and 1989 were reviewed and reclassified histopathologically and immunohistochemically.There were 21 boys and 5 girls with a mean age of 9.0 years. Major primary sites were head and neck (50.0%) and abdomen (23.0%). Non-localized type (stage III and IV) were 76.9% of the patients and localized type (stage I and II) were 23.1% at the time of diagnosis according to the Murphy's classification.Histopathologically, 26 cases divided into three major subtypes: lymphoblastic type (30.8%), large cell type (34.6%), and Burkitt type (30.8%).Immunohistochemically, it was demonstrated that 13 cases of 26 cases were T cell origin and 11 cases were B cell origin. There was no case of non-T non-B.In lymphoblastic type and Burkitt type, histology was found to correlate strongly with immunophenotype and biologic behavior, but in the cases of large cell type they were heterogeneous.In 9 cases of large cell lymphoma, 4 cases were T cell lymphoma, 2 cases were B cell lymphoma and 3 cases were Ki-1 positive lympoma.Complete remission was obtained in 23 of 26 cases (88.5%), 100% in lymphoblastic type, 75.0% in large cell type and 87.5% in Burkitt type. Two-year-survival rate was 100% in lymphoblastic type, 56.3% in large cell type and 83.3% in Burkitt type. Seven-year-survival rate was 75.0%, 56.3%, and 83.3%, respectively. Large cell type lymphomas had the worst prognosis.