Shimazaki Kae, Ohshima K, Haraoka S, Suzumiya J, Nakamura N, Kikuchi M
Department of Pathology, School of Medicine, Fukuoka University, Nanakuma 7-45-1, Jonanku, Fukuoka 814-0180, Japan.
Histopathology. 2002 Jan;40(1):12-21. doi: 10.1046/j.1365-2559.2002.01337.x.
Lymph nodes contain non-lymphoid accessory cells including follicular dendritic cells and interdigitating dendritic cells. Functionally, these cells belong to the category of immune accessory cells involved in antigen presentation to B or T-lymphocytes. Neoplastic proliferation of these cells is very uncommon. We present here the clinicopathological features of 16 cases of accessory cell tumour.
We performed electron microscopic and immunohistochemical examinations, and used in-situ hybridization for EBV-encoded RNA (ISH-EBV) to detect the EBV genome in 11 cases, and Southern blot analysis to assess EBV clonality in two cases. Tumour cells were composed of oval-to-spindle cells arranged in diffuse, vague storiform, fascicular and sometimes whorled patterns in a background of small lymphocytes. In all cases, binucleated or multinucleated Hodgkin and Reed-Sternberg-like giant cells were encountered. Staining for CD68 was positive in all cases. CD21, CD35, Ki-M4p, Ki-FDC1p, and S100 exhibited variable reactivity. ISH-EBV yielded positive labelling in seven of 11 cases, of which five exhibited EBV only in Hodgkin and Reed-Sternberg-like giant cells. Southern blot analysis showed clonality of EBV terminal repeats (EBV-TR) in the two cases examined. Electron microscopic examination showed that many of the tumour cells had numerous interwoven long villous cell processes connected by occasional desmosomes. Many tumours were very refractory to chemotherapy and radiation, with a few exceptions, and half of the cases classified initially as stage IV. A short survival time, of 10 months or less, was observed in seven of 16 patients.
Our study identified more aggressive behaviour of accessory cell tumours. Our results suggest that EBV may potentially induce activation of accessory cells to form Hodgkin and Reed-Sternberg-like giant cells, which correspond with poor prognosis.
淋巴结包含非淋巴细胞辅助细胞，包括滤泡树突状细胞和交错突细胞。在功能上，这些细胞属于参与向B或T淋巴细胞呈递抗原的免疫辅助细胞类别。这些细胞的肿瘤性增殖非常罕见。我们在此呈现16例辅助细胞肿瘤的临床病理特征。
我们进行了电子显微镜和免疫组织化学检查，对11例使用原位杂交检测EBV编码RNA（ISH-EBV）以检测EBV基因组，并对2例进行Southern印迹分析以评估EBV克隆性。肿瘤细胞由椭圆形至梭形细胞组成，在小淋巴细胞背景中呈弥漫性、模糊的席纹状、束状，有时呈漩涡状排列。在所有病例中，均可见双核或多核霍奇金和里德-斯腾伯格样巨细胞。所有病例中CD68染色均为阳性。CD21、CD35、Ki-M4p、Ki-FDC1p和S100表现出不同的反应性。ISH-EBV在11例中的7例中产生阳性标记，其中5例仅在霍奇金和里德-斯腾伯格样巨细胞中显示EBV。Southern印迹分析显示在所检查的2例中EBV末端重复序列（EBV-TR）具有克隆性。电子显微镜检查显示许多肿瘤细胞有许多相互交织的长绒毛状细胞突起，偶尔通过桥粒相连。除少数例外，许多肿瘤对化疗和放疗非常难治，半数病例最初分类为IV期。16例患者中有7例观察到短生存时间，即10个月或更短。
我们的研究确定了辅助细胞肿瘤更具侵袭性的行为。我们的结果表明EBV可能潜在地诱导辅助细胞活化以形成霍奇金和里德-斯腾伯格样巨细胞，这与预后不良相关。
