中华病理学杂志
中華病理學雜誌
중화병이학잡지
Chinese Journal of Pathology
2009年
4期
224-230
,共7页
唐雪峰%李甘地%李亚林%梁冬妮%夏天%周继雍%姚宇琪%吴文乔%王占贵%杨永红%汤显斌%白燕琼%丁强
唐雪峰%李甘地%李亞林%樑鼕妮%夏天%週繼雍%姚宇琪%吳文喬%王佔貴%楊永紅%湯顯斌%白燕瓊%丁彊
당설봉%리감지%리아림%량동니%하천%주계옹%요우기%오문교%왕점귀%양영홍%탕현빈%백연경%정강
淋巴瘤,T细胞%免疫表型分型%诊断,鉴别
淋巴瘤,T細胞%免疫錶型分型%診斷,鑒彆
림파류,T세포%면역표형분형%진단,감별
Lymphoma,T-cell%Immunophenotyping%Diagnosis,differential
目的 探讨CXCL13、CD10、bcl-6等标志物在血管免疫母细胞性T细胞淋巴瘤(AITL)的诊断和鉴别诊断中的作用.方法 对四川大学华西医院病理科1990年1月至2008年1月诊断的115例AITL、30例非特指外周T细胞淋巴瘤(PTCL,NOS)和30例以副皮质区增生为主的反应性增生(RH)进行回顾性分析.按2008版WHO关于淋巴造血组织肿瘤分类进行组织学分型,采用9种抗原标志物的免疫组织化学(SP法)染色及TCR-γ基因重排检测.结果 (1)7.8%(9/115)的AITL、6.7%(2/30)的PTCL,NOS和83.3%(25/30)的RH病例观察到生发中心;98.3%(113/115)的AITL、63.3%(19/30)的FTCL,NOS和76.7%(23/30)的RH病例观察到显著血管增生.(2)CXCL13、CD10、bcl-6在RH病例的表达局限在生发中心,在AITL的表达率分别为96.5%(111/115)、50.4%(58/115)和78.3%(90/115),在PTCL,NOS的表达率分别为26.7%(8/30)、3.3%(1/30)和3.3%(1/30),以上三个标记在两种淋巴瘤的表达率差异均具有统计学意义.115例AITL病例均见到滤泡外不规则分布的CD21阳性的滤泡树突状细胞网(FDC).TCR-γ基因克隆性重排在AITL中检出率为83%(83/100).结论 AITL是一种来源于生发中心辅助性T细胞(TFH)的高度侵袭性肿瘤,CXCL13、CD10、bcl-6是AITL诊断和鉴别诊断有用标志物.
目的 探討CXCL13、CD10、bcl-6等標誌物在血管免疫母細胞性T細胞淋巴瘤(AITL)的診斷和鑒彆診斷中的作用.方法 對四川大學華西醫院病理科1990年1月至2008年1月診斷的115例AITL、30例非特指外週T細胞淋巴瘤(PTCL,NOS)和30例以副皮質區增生為主的反應性增生(RH)進行迴顧性分析.按2008版WHO關于淋巴造血組織腫瘤分類進行組織學分型,採用9種抗原標誌物的免疫組織化學(SP法)染色及TCR-γ基因重排檢測.結果 (1)7.8%(9/115)的AITL、6.7%(2/30)的PTCL,NOS和83.3%(25/30)的RH病例觀察到生髮中心;98.3%(113/115)的AITL、63.3%(19/30)的FTCL,NOS和76.7%(23/30)的RH病例觀察到顯著血管增生.(2)CXCL13、CD10、bcl-6在RH病例的錶達跼限在生髮中心,在AITL的錶達率分彆為96.5%(111/115)、50.4%(58/115)和78.3%(90/115),在PTCL,NOS的錶達率分彆為26.7%(8/30)、3.3%(1/30)和3.3%(1/30),以上三箇標記在兩種淋巴瘤的錶達率差異均具有統計學意義.115例AITL病例均見到濾泡外不規則分佈的CD21暘性的濾泡樹突狀細胞網(FDC).TCR-γ基因剋隆性重排在AITL中檢齣率為83%(83/100).結論 AITL是一種來源于生髮中心輔助性T細胞(TFH)的高度侵襲性腫瘤,CXCL13、CD10、bcl-6是AITL診斷和鑒彆診斷有用標誌物.
목적 탐토CXCL13、CD10、bcl-6등표지물재혈관면역모세포성T세포림파류(AITL)적진단화감별진단중적작용.방법 대사천대학화서의원병이과1990년1월지2008년1월진단적115례AITL、30례비특지외주T세포림파류(PTCL,NOS)화30례이부피질구증생위주적반응성증생(RH)진행회고성분석.안2008판WHO관우림파조혈조직종류분류진행조직학분형,채용9충항원표지물적면역조직화학(SP법)염색급TCR-γ기인중배검측.결과 (1)7.8%(9/115)적AITL、6.7%(2/30)적PTCL,NOS화83.3%(25/30)적RH병례관찰도생발중심;98.3%(113/115)적AITL、63.3%(19/30)적FTCL,NOS화76.7%(23/30)적RH병례관찰도현저혈관증생.(2)CXCL13、CD10、bcl-6재RH병례적표체국한재생발중심,재AITL적표체솔분별위96.5%(111/115)、50.4%(58/115)화78.3%(90/115),재PTCL,NOS적표체솔분별위26.7%(8/30)、3.3%(1/30)화3.3%(1/30),이상삼개표기재량충림파류적표체솔차이균구유통계학의의.115례AITL병례균견도려포외불규칙분포적CD21양성적려포수돌상세포망(FDC).TCR-γ기인극륭성중배재AITL중검출솔위83%(83/100).결론 AITL시일충래원우생발중심보조성T세포(TFH)적고도침습성종류,CXCL13、CD10、bcl-6시AITL진단화감별진단유용표지물.
Objective To study the value of immunomarkers CXCL13, CD10, bcl-6 in pathologic diagnosis of angioimmunoblastic T-cell lymphoma (AITL). Methods One hundred and fifteen cases of AITL, 30 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) and 30 cases of rescfive lymph nodes with paracortical hyperplasia (RH) encountered during the period from January, 1990 to January, 2008 were retrieved from the archival files of the Department of Pathology, West China Hospital of Sichuan University, China. The morphologie features were reviewed and compared. Immunohisto- chemical study was performed by SP method for CXCL13, CD10, bcl-6, CD21, CD3ε, CD3, CD45RO, CD20 and Ki-67. TCR-γ gene rearrangement study was also carried out. Results Regressed follicles were evident in 7.8% (9/115) of AITL cases, 6.7% (2/30) of PTCL, NOS cases and 83.3% (25/30) of RH cases, respectively. A marked increase of number of arborizing venules was shown in 98.3% (113/115) of AITL cases, 63.3% (19/30) of PTCL, NOS cases and 76.7% (23/30) of RH cases, respectively. In lymph nodes with paracortieal hyperplasia, the expression of CXCL13, CD10 and bel-6 were restricted to the germinal centers. In AITL, 96.5% (111/115) of cases showed CXCL13 expression, in contrast to 26.7% (8/30) of PTCL, NOS. Expression of CD10 and bcl-6 were found in the neoplastic cells in 50.4% (58/115) and 78.3% (90/115) of AITL, and 3.3% (1/30) and 3.3% (1/30) of PTCL, NOS, respectively, Irregular meshworks of CD21-positive follicular dendritic cells were found in all the AITL cases. Clonal TCR-γ rearrangement was detected in 83% (83/100) of the AITL cases. Conclusions AITL is a type of lymphoma originated from the follicular helper T cells. Detailed morpholngic assessment and use of intmunohistochemical markers are essential for accurate diagnosis.
