Saffer Helene, Wahed Amer, Rassidakis Georgios Z, Medeiros L Jeffrey
Department of Pathology, The University of Texas-Houston Health Sciences Center, The University of Texas-M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Mod Pathol. 2002 Nov;15(11):1221-6. doi: 10.1097/01.MP.0000036386.87517.AA.
Clusterin expression has been reported to be characteristic of systemic anaplastic large cell lymphoma and usually negative in cutaneous anaplastic large cell lymphoma as well as other lymphoma types. We surveyed clusterin expression using immunohistochemical methods in 266 cases of non-Hodgkin's lymphoma and Hodgkin's disease to further assess the diagnostic utility of this marker. Clusterin immunostaining was observed in 40 of 49 (82%) systemic anaplastic large cell lymphomas and 12 of 29 (41%) cutaneous anaplastic large cell lymphomas. Clusterin also was expressed in 5 of 43 (12%) diffuse large B-cell lymphomas (4 of 5 CD30+), 1 of 14 (7%) peripheral T-cell lymphomas, 1 of 32 (3%) cases of nodular sclerosis Hodgkin's disease, and 1 case of mycosis fungoides in large cell transformation. Clusterin was negative in all other neoplasms assessed including follicular lymphoma of all grades (n = 24), mantle cell lymphoma (n = 13), marginal zone B-cell lymphoma (n = 12), precursor T-cell or B-cell lymphoblastic leukemia/lymphoma (n = 10), mixed cellularity Hodgkin's disease (n = 8), chronic lymphocytic leukemia/small lymphocytic lymphoma (n = 7), Burkitt lymphoma (n = 7), mycosis fungoides (n = 4), nodular lymphocyte predominant Hodgkin's disease (n = 3), lymphoplasmacytic lymphoma/Waldenstrom macroglobulinemia (n = 2), and plasmacytoma (n = 2). We conclude that clusterin is a marker of anaplastic large cell lymphoma and that addition of clusterin to antibody panels designed to distinguish systemic anaplastic large cell lymphoma from classical Hodgkin's disease is useful. However, clusterin is also positive in a substantial subset of cutaneous anaplastic large cell lymphomas, a smaller subset of diffuse large B-cell lymphomas, and rarely in cases of peripheral T-cell lymphoma and nodular sclerosis Hodgkin's disease.
据报道，簇集素表达是系统性间变性大细胞淋巴瘤的特征，在皮肤间变性大细胞淋巴瘤以及其他淋巴瘤类型中通常为阴性。我们采用免疫组化方法对266例非霍奇金淋巴瘤和霍奇金病病例进行簇集素表达检测，以进一步评估该标志物的诊断效用。在49例系统性间变性大细胞淋巴瘤中有40例（82%）观察到簇集素免疫染色，在29例皮肤间变性大细胞淋巴瘤中有12例（41%）观察到。簇集素在43例弥漫性大B细胞淋巴瘤中的5例（12%）（5例中有4例CD30阳性）、14例外周T细胞淋巴瘤中的1例（7%）、32例结节硬化型霍奇金病病例中的1例（3%）以及1例大细胞转化的蕈样肉芽肿病例中也有表达。在所有其他评估的肿瘤中簇集素均为阴性，包括所有分级的滤泡性淋巴瘤（n = 24）、套细胞淋巴瘤（n = 13）、边缘区B细胞淋巴瘤（n = 12）、前体T细胞或B细胞淋巴母细胞白血病/淋巴瘤（n = 10）、混合细胞型霍奇金病（n = 8）、慢性淋巴细胞白血病/小淋巴细胞淋巴瘤（n = 7）、伯基特淋巴瘤（n = 7）、蕈样肉芽肿（n = 4）、结节性淋巴细胞为主型霍奇金病（n = 3）、淋巴浆细胞淋巴瘤/华氏巨球蛋白血症（n = 2）以及浆细胞瘤（n = 2）。我们得出结论，簇集素是间变性大细胞淋巴瘤的标志物，在用于区分系统性间变性大细胞淋巴瘤与经典霍奇金病的抗体组合中加入簇集素是有用的。然而，簇集素在相当一部分皮肤间变性大细胞淋巴瘤、一小部分弥漫性大B细胞淋巴瘤中也呈阳性，在外周T细胞淋巴瘤和结节硬化型霍奇金病病例中则很少呈阳性。
