摘要
目的探讨细胞角蛋白阳性淋巴结间质网状细胞肿瘤（CIRCT）的临床病理学特征、组织发生、生物学行为及预后。方法应用光镜、免疫组化染色及电镜观察1例男性患者腹膜后CIRCT的组织病理学特点，并结合文献进行讨论。结果光镜下淋巴结结构大部分破坏，代之以大量呈席纹状、束状或不规则排列的梭形瘤细胞；瘤细胞胞膜不清，胞质淡伊红染，核轻度异型，核膜清晰，呈空泡状，核仁明显，可见病理性核分裂象0～2个／10HPF。瘤细胞vimentin、CK8／18、SMA和EGFR（＋），CD21＋35、clusterin、CD1a、desmin、S-100、CD68和ALK-1（-）。电镜下瘤细胞表面有纤细的胞质突起，相互交错排列，细胞间见发育不良的桥粒样结构，单个细胞外或细胞巢间有基底膜样物质和长间距胶原围绕。结论CIRCT起源于淋巴结辅助树突状细胞中的纤维母细胞性网状细胞（FBRC），非常少见，易被误诊为其他辅助树突状细胞肿瘤甚至转移癌，免疫组化检查是确诊的主要依据，电镜检查也极具参考价值。
Purpose To study the cllnicopathologie characteristics, pathogenesis, biological behavior and prognosis of cytokeratin-positive interstitial retictdum cell tumor （CIRCr） in lymph node. Methods A case of CIRCr occurring in retmperitoneum was investigated by light microscopy, immunohistochemistry and electron microscopy. The histopatholngie features were discussed with review of the literature. Results The structure of the lymph node was almost effaced by the neoplastic proliferation of the spindle cells arranged in a diffuse fascicular, storiform growth pattern or irregularly. The tumor cells had eosinophilic cytoplasm and mildly atypical nuclei. The nuclei were vesicular with prominent nucleoli and distinct nuclear membrane. The mitotic rate was 0-2 mitotic figures per 10 high-power fields. The tumor cells were positive for vimentin, CK8/18, SMA and EGFR, but negative for CD21 ＋ 35, clusterin, CDla, S-100, CD68, desmin and ALK-1. Uhrastructurally, the tumor cells contained slender, interlacing cytoplasmic processes, dysplastic desmosome-like junctions. Around tumor cells were basement membrane-like material and long-spacing collagen. Conclusions CIRCT is derived from frbmblastic reticulum cells （FBRCs） which belong to accessory dendritic cells in lymph node. It is a rare tumor and easily misdiagnosed stmning is the main evidence for diagnosis and electron microscopic examination also plays an important role in diagnosis.
出处
《诊断病理学杂志》
CSCD
2009年第2期107-111,共5页
Chinese Journal of Diagnostic Pathology
基金
国家基金研究9732项目(2006,CB705707)
南京军医医学科学技术研究“十一五”计划重点课题(06237)
