Abstract
We propose dividing histologically reactive lymphoid hyperplasia (RLH) of the stomach into two categories: atypical lymphoid hyperplasia (ALH), characterized by abnormal follicular architecture and infiltration of atypical lymphoid cells, and benign lymphoid hyperplasia (BLH), where normal follicular patterns are preserved and no atypical cells are found. Using twenty RLH cases (10 ALHs and 10 BLHs), both categories were compared front histopathological and immunohistochemical aspects. Macroscopic division into superficial, thick‐walled and nodular types revealed most ALH (80%) to be superficial in character whereas in BLH superficial and thick‐walled types were almost equally represented. Lesion size tended to be larger in ALH (> 6.1 cm) than in BLH (6.0 cm >) cases. As for prognosis after gastrectomy, both categories were favorable. On immunohistochemistry, ALH tended to be strongly labeled by B lymphocyte markers as compared to BLH, where only a weakly positive reaction was expressed. Infiltration of cells labeled by T lymphocyte markers was less conspicuous in ALH than in BLH. From these data, we concluded that ALH and BLH are two distinctive categories of lesion and that ALH has characteristics similar to these demonstrated by malignant lymphoma.
Keywords: Key words, Reactive lymphoid hyperplasia, Atypical lymphoid hyperplasia, Benign lymphoid hyperplasia, Immunohistochemistry, Stomach
Full Text
The Full Text of this article is available as a PDF (530.5 KB).
REFERENCES
- 1. ) Smith , J. L. and Helwig , E. B.Malignant lymphoma of the stomach: its diagnosis, distinction and biologic behavior . Am. J. Pathol. , 34 , 553 ( 1958. ). [Google Scholar]
- 2. ) Nakamura , K. , Aoki , M. , Sugano , H. and Takagi , K.Reactive lymphoreticular hyperplasia of the stomach; six cases and their discussion . Gann to Rinsho , 12 , 691 – 696 ( 1966. ) ( in Japanese ). [PubMed] [Google Scholar]
- 3. ) Faris , T. D. and Saltzstein , S. L.Gastric lymphoid hyperplasia: a lesion confused with lymphosarcoma . Cancer , 17 , 207 – 212 ( 1964. ). [DOI] [PubMed] [Google Scholar]
- 4. ) Perez , C. A. and Dorfman , R. F.Benign lymphoid hyperplasia of the stomach and duodenum . Radiology , 87 , 505 – 510 ( 1966. ). [DOI] [PubMed] [Google Scholar]
- 5. ) Mattingly , S. S. , Cibull , M. L. , Ram , M. D. , Hagihara , P. R. and Griffen , W. O.Pseudolymphoma of the stomach . Arch. Surg. , 116 , 25 – 29 ( 1981. ). [DOI] [PubMed] [Google Scholar]
- 6. ) Tewfik , H. , Platz , C. , Corder , M. , Panther , S. and Blodi , F.A clinico‐pathologic study of orbital and adnexal non‐Hodgkin's lymphoma . Cancer , 44 , 1022 – 1028 ( 1979. ). [DOI] [PubMed] [Google Scholar]
- 7. ) Lapes , M. , Antoniades , K. , Gartner , W. and Divacqua , R.Conversion of a benign lymphoepithelial salivary gland lesion to lymphocytic lymphoma during dilantin therapy . Cancer , 38 , 1318 – 1322 ( 1976. ). [DOI] [PubMed] [Google Scholar]
- 8. ) Wolf , J. A. and Spjut , H. J.Focal lymphoid hyperplasia of the stomach preceding gastric lymphoma: case report and review of the literature . Cancer , 48 , 2518 – 2523 ( 1981. ). [DOI] [PubMed] [Google Scholar]
- 9. ) Brooks , J. J. and Enterline , H. T.Gastric pseudolymphoma: its three subtypes and relation to lymphoma . Cancer , 51 , 476 – 486 ( 1983. ). [DOI] [PubMed] [Google Scholar]
- 10. ) Isaacson , P. G. , Spencer , J. and Finn , T.Primary B cell gastric lymphoma . Hum. Pathol. , 17 , 72 – 86 ( 1986. ). [DOI] [PubMed] [Google Scholar]
- 11. ) Saraga , P. , Hurlimann , J. and Ozzello , L.Lymphomas and pseudolymphomas of the alimentary tract; an immunohistochemical study with clinicopathologic correlations . Hum. Pathol. , 12 , 713 – 722 ( 1981. ). [DOI] [PubMed] [Google Scholar]
- 12. ) Eimoto , T. , Futami , K. , Naito , H. , Takeshita , M. and Kikuchi , M.Gastric pseudolymphoma with monotypic cytoplasmic immunoglobulin . Cancer , 55 , 788 – 793 ( 1985. ). [DOI] [PubMed] [Google Scholar]
- 13. ) Mohri , N.Primary gastric non‐Hodgkin's lymphomas in Japan . Virchows Arch. A , 411 , 459 – 466 ( 1987. ). [DOI] [PubMed] [Google Scholar]
- 14. ) Scoazec , J. , Brousse , N. , Potet , F. and Jeulain , J.Focal malignant lymphoma in gastric pseudolymphoma; histo‐logic and immunohistochemical study of a case . Cancer , 57 , 1330 – 1336 ( 1986. ). [DOI] [PubMed] [Google Scholar]
- 15. ) Spencer , J. , Diss , T. C.and Isaacson, P. G. Primary B cell gastric lymphoma. A genotypic analysis . Am. J. Pathol. , 135 , 557 – 564 ( 1989. ). [PMC free article] [PubMed] [Google Scholar]
- 16. ) Tokunaga , O. , Watanabe , T. and Morimatsu , M.Pseudolymphoma of the stomach . Cancer , 59 , 1320 – 1327 ( 1987. ). [DOI] [PubMed] [Google Scholar]
- 17. ) Nathwani , B. N. and Brynes , R. K.Reactive immuno‐blastic proliferations . Semin. Diagn. Pathol. , 5 , 317 – 328 ( 1988. ). [PubMed] [Google Scholar]
