摘要
目的探讨淋巴滤泡树突细胞(follicular dendritic cell,FDC)网(简称FDC网)的形态变化在淋巴组织增生良恶性病变鉴别诊断中的应用价值。方法采用免疫组化EnVision两步法对淋巴组织反应性增生60例、透明血管型Castleman病(hya-line vascular type Castleman disease,HV-CD)5例、T区不典型增生3例、不同类型淋巴瘤78例(非霍奇金淋巴瘤73例,霍奇金淋巴瘤5例)病变中的FDC网形态变化进行观察和分型。在淋巴组织良恶性增生病变常用的免疫组化抗体套餐中加用CD21/CD35抗体标记FDC网。结果反应性增生病变均为球形网,表面完整,网格规则。HV-CD为单个或多个不规则球形网或为特殊的蛇形网。T区不典型增生或早期套细胞淋巴瘤(mantle cell lymphoma,MCL)、边缘区淋巴瘤(marginal zone lym-phoma,MZL)为表面侵蚀网。浸润性MCL、MZL、T区淋巴瘤及弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DL-BCL)、非生发中心B细胞亚型(germinal center B cell,GCB)一般为殖入性撕裂网,生发中心源B细胞淋巴瘤,偶见弥漫性MCL为碎爆裂网。滤泡性淋巴瘤(follicular lymphoma,FL)、结节性淋巴细胞为主型霍奇金淋巴瘤(nodular lymphocyte predomi-nant Hodgkin lymphoma,N-LPHL)、结节性经典型富于淋巴细胞性霍奇金淋巴瘤(nodular lymphocyte-rich classical Hodgkin lym-phoma,N-LRCHL)、结节硬化经典型霍奇金淋巴瘤(nodular sclerosis clssical hodgkin lymphoma,NSCHL)为结节性增殖网。血管免疫母细胞性T细胞淋巴瘤(angioimmunoblastic T-cell lymphoma,AITL)为特有的滤泡外围血管增生网。结论淋巴组织增生病变中FDC网的形态变化在良恶性病变中存在明显差异。将FDC网形态变化结合淋巴组织增生病变病理组织学、免疫组化及分子遗传学检测是良恶性病变的有效鉴别指标之一。
Purpose To explore the differentiated diagnostic value of the morphological changes of follicular dendritic cell （FDC） meshwork between benign and malignant lymphoid proliferation lesions. Method The morphologic analysis and type of follucular den- dritic cell （FDC） meshwork was studied by EnVision two-step methods in 60 cases of reactive lymphoid hyperplasia, 5 cases of HV- CD, 3 cases of atypical hyperplasia of T zone, and 78 cases of various lymphomas （ 73 cases of non-Hodgkin lymphoma and 5 cases of Hodgkin lymphoma）. A panel of antibodies used in the benign and malignant lymphoid hyperplasia lesions plus CD21/CD35 were used to label FDC meshwork. Results The reactive hyperplastie lesions showed ball form and regulated meshwork which has intact surface. The HV-CD showed single or multiple ball meshwork or distinct snake-like meshwork. The T zone atypical hyperplasia, early MCL and MZL showed surface invasive meshwork. The diffuse infiltrative MCL, MZL, T zone lymphoma and DLBCL non-GCB showed coloniza- tire meshwork. The DLBCL GCB and diffuse MCL showed burst meshwork. The FL, NLPHL, NLRCHL and NSCHL showed prolifera- tive meshwork. The AITL showed specific extra.follicular around vessel proliferative meshwork. Conclusion All observed results sug- gest the morphologie changes of FDC meshwork between benign and malignant lymphoid proliferative lesions showed obvious difference. The morphologic changes of FDC meshwork combined with the histopathology, immunohistoehemistry and molecular genetic detection may helpful for the differential diagnosis between benign and malignant of lymphoid proliferative lesions.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2012年第11期1231-1234,共4页
Chinese Journal of Clinical and Experimental Pathology
关键词
淋巴组织增生病变
滤泡树突细胞网
鉴别诊断
lymphoid tissue proliferative lesions
FDC meshwork
differential diagnosis
