Babusíková O, Tomová A
Cancer Research Institute; Slovak Academy of Sciences, Bratislava, 83391 Slovakia.
Neoplasma. 2002;49(5):312-8.
In our study we described the immunophenotypic characteristics of an ectopic thymus found in an eight month old male baby. Comparing with the results of normal thymic cells we did not found any difference or abnormalities in the phenotype. A brief discussion of theories of histogenesis and possible differential diagnosis of ectopic thymus is included. The most common immune pattern of both, ectopic and normal thymuses, was expression of TdT,CD7,cCD3,CD1 and dual CD4/CD8. Early results of immunological examination confirmed by histopathology stated the diagnosis of ectopic thymus and excluded other causes (infection, trauma, neoplasm and congenital abnormalities). The study of both, ectopic and normal thymic tissue provides a perfect model for comparative analysis of some T-acute lymphoblastic leukemia (T-ALL). Both, thymocytes and some cases of our T-ALL (20 of 48 examined T-ALL) had a specific late cortical T-cell phenotype. We observed new qualities of both, thymic cells and T-ALL cells of a late cortical phenotype that resulted in cell populations localized in the so-called "empty spaces", in fluorescence histograms, that might be discriminated from internal T-cell populations with normal antigen expression. An important sign of T-ALL in common is to display aberrant marker combinations and the tendency to drop specific normal T-cell antigens. Aberrant markers were present in our study in a phenotypic group of a late cortical T-ALL in 11 cases (55.0%) of the 20 studied. As aberrant markers we observed mostly CD10, CD34, HLA-DR and CD13. Furthermore, the tendency to drop specific normal T-cell markers could be recognized in one case of a late cortical T-ALL in the form of TCRab and TCRgd absence. DNA analysis did not reveal any changes in proliferation index either in thymocytes (normal or ectopic), or in T-ALL of a late cortical T-cell phenotype. Based on our findings the clinical utility of comparing the results obtained from the immunophenotypic characterization of healthy hematopoietic and leukemia cells can be concluded. An exact and early diagnosis of hematopoietic disorders (ectopic thymus, T-ALL and T-NHL) and identification of identical phenotypic patterns at different times (for more exact minimal residual disease detection during and after therapy) could be obtained.
在我们的研究中,我们描述了一名8个月大男婴体内发现的异位胸腺的免疫表型特征。与正常胸腺细胞的结果相比,我们未发现表型上有任何差异或异常。文中还包括了关于组织发生理论以及异位胸腺可能的鉴别诊断的简要讨论。异位胸腺和正常胸腺最常见的免疫模式是末端脱氧核苷酸转移酶(TdT)、CD7、胞质CD3(cCD3)、CD1以及CD4/CD8双表达。经组织病理学证实的免疫学检查早期结果明确了异位胸腺的诊断,并排除了其他病因(感染、创伤、肿瘤和先天性异常)。对异位胸腺和正常胸腺组织的研究为某些T细胞急性淋巴细胞白血病(T-ALL)的比较分析提供了一个完美模型。胸腺细胞以及我们研究的部分T-ALL病例(48例受检T-ALL中的20例)都具有特定的晚期皮质T细胞表型。我们观察到晚期皮质表型的胸腺细胞和T-ALL细胞都具有新的特性,这导致在荧光直方图中细胞群体定位于所谓的“空白区域”,这些细胞群体可能与具有正常抗原表达的内部T细胞群体区分开来。T-ALL的一个重要共同特征是显示异常的标志物组合以及丢失特定正常T细胞抗原的倾向。在我们的研究中,20例研究对象中有11例(55.0%)晚期皮质T-ALL表型组存在异常标志物。我们观察到的异常标志物主要有CD10、CD34、人类白细胞抗原DR(HLA-DR)和CD13。此外,在1例晚期皮质T-ALL中可识别出丢失特定正常T细胞标志物的倾向,表现为T细胞受体αβ(TCRab)和T细胞受体γδ(TCRgd)缺失。DNA分析未发现胸腺细胞(正常或异位)或晚期皮质T细胞表型的T-ALL的增殖指数有任何变化。基于我们的研究结果,可以得出比较健康造血细胞和白血病细胞免疫表型特征所获结果的临床实用性。可以实现对造血系统疾病(异位胸腺、T-ALL和T细胞非霍奇金淋巴瘤)的准确早期诊断,以及在不同时间识别相同的表型模式(以便在治疗期间和治疗后更准确地检测微小残留病)。