CAJ | 학술논문

目的探讨炎性假瘤样滤泡树突细胞肿瘤的临床病理学特征.方法观察1例脾脏的炎性假瘤样滤泡树突细胞肿瘤的大体和光镜形态,免疫组织化学EnVision法检测CD21、CD23、CD35、Clusterin、S-100、波形蛋白、平滑肌肌动蛋白(SMA)、CD1a、CD68、间变型淋巴瘤激酶(ALK)、CD30、CD31、CD34、CD3、CD20,原位杂交检测EBER,并结合文献复习分析其生物学行为和病因机制.结果炎性假瘤样滤泡树突细胞肿瘤好发于腹腔内脏器,尤以肝、脾多见,患者以女性为主.一般肿瘤较大,切面灰白质韧,中心有出血或坏死.镜下大量淋巴细胞、浆细胞背景中见弥散分布的滤泡树突细胞,形似炎性假瘤.高倍镜下滤泡树突细胞胞质淡染,胞界不清,核卵圆形或杆状,染色质空泡样或点彩状,居中可见小的紫色核仁.部分瘤细胞显示异型性,核膜皱褶,染色质粗糙,核仁明显.核分裂象罕见.免疫组织化学:梭形瘤细胞波形蛋白强阳性;Clusterin、SMA、CD68均阳性;CD35局部弱阳性,S-100弱阳性;CD21、CD23、CDla,ALK、CD30、CD31、CD34均阴性.背景淋巴细胞CD3阳性,灶性区CD20阳性.原位杂交:梭形瘤细胞EBER阳性.结论炎性假瘤样滤泡树突细胞肿瘤是一种罕见的低度恶性肿瘤,与EB病毒感染有关.
목적 탐토염성가류양려포수돌세포종류적림상병이학특정.방법 관찰1례비장적염성가류양려포수돌세포종류적대체화광경형태,면역조직화학EnVision법검측CD21、CD23、CD35、Clusterin、S-100、파형단백、평활기기동단백(SMA)、CD1a、CD68、간변형림파류격매(ALK)、CD30、CD31、CD34、CD3、CD20,원위잡교검측EBER,병결합문헌복습분석기생물학행위화병인궤제.결과 염성가류양려포수돌세포종류호발우복강내장기,우이간、비다견,환자이녀성위주.일반종류교대,절면회백질인,중심유출혈혹배사.경하대량림파세포、장세포배경중견미산분포적려포수돌세포,형사염성가류.고배경하려포수돌세포포질담염,포계불청,핵란원형혹간상,염색질공포양혹점채상,거중가견소적자색핵인.부분류세포현시이형성,핵막추습,염색질조조,핵인명현.핵분렬상한견.면역조직화학:사형류세포파형단백강양성;Clusterin、SMA、CD68균양성;CD35국부약양성,S-100약양성;CD21、CD23、CDla,ALK、CD30、CD31、CD34균음성.배경림파세포CD3양성,조성구CD20양성.원위잡교:사형류세포EBER양성.결론 염성가류양려포수돌세포종류시일충한견적저도악성종류,여EB병독감염유관.
Objective To study the clinicopathologic features of inflammatory pseudotumor-like follicular dendritic cell tumor of spleen.Methods One case of inflammatory pseudotumor-like foilicular dendritic cell tumor of spleen was examined macroscopically and microscopically.Immunohistochemical study for CD21,CD23,CD35,clusterin,S-100 protein,vimentin,smooth muscle actin,CD1a,CD68,ALK protein,CD30,CD31,CD34,CD3 and CD20 was performed on formalin-fixed.paraffin-embedded sections by standard EnVision method.In-situ hybridization for Epstein-Barr virus(EBV)-encoded RNA was also carried out.Resuits Macroscopically,inflammatory pseudotumor-like follicular dendritic cell tumor was large in size,tan-colored.soft to rubbery in consistance and associated with central hemorrhage and necrosis.Histological examination showed scattered follicular dendritic cells admixed with abundant lymphocytes and plasma cells in the background,simulating inflammatory pseudotumor.On high-power magnification,the follicular dendritic cells possessed a moderate amount of pale to lighdy eosinophilic cytoplasm,with indistinct cell borders.The nuclei were ovoid or spindly.with vesicular or stippled chromatin and small distinct.often centrally located.nucleoli.Some of tlle tumor cells showed nuclear pleomorphism and contained irregular foldings of nuclear membrane,coarse chromatin and prominent eosinophilic nucleoli.Mitotic figures were rarely identified.Immunohistochemical study showed that the tumor cells were positive for vimentin.clusterin.smooth muscle actin and CD68.They were weakly and focally positive for CD35 and S-100 protein,but negative for CD21,CD23,CD1a,ALK protein,CD30,CD31 and CD34.Most of the background lymphocytes were of T-lineage(CD3-positive),some were CD20(B-cell marker).positive.EBV RNA was demonstrated in the tumor ceils by in-situ hybridization analysis.Conclusions Inflammatory pseudotumor-like foilicular dendritic cell tumor is a rarely encountered low-grade malignancy with distinctive morphologie pattern.It is associated with EBV infection.