Chen Xinjian, Jensen Peter E, Li Shiyong
Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Am J Clin Pathol. 2003 Jun;119(6):842-51. doi: 10.1309/WP6H-6UD4-DXMR-Q86T.
HLA-DO expression is regulated during B-cell development and activation. To determine whether the level of HLA-DO expression is a helpful marker in the differential diagnosis between florid follicular hyperplasia and follicular lymphoma, we analyzed single-cell suspensions from 29 lymph node specimens by 4-color flow cytometry. Of the 29 specimens, 7 were from patients with florid follicular hyperplasia, in which the clonality of the germinal center B cells (GCBCs) was indeterminate by flow cytometric immunophenotyping. The remaining 22 cases were follicular lymphomas; neoplastic cells in 2 of these cases lacked expression of surface immunoglobulin light chains. The level of HLA-DO expression in the reactive CD10+ GCBCs in florid follicular hyperplasia was markedly down-regulated compared with the CD10- polytypic B cells of the same specimens. In contrast, the level of HLA-DO expression in the CD10+ neoplastic cells in all cases of follicular lymphomas was similar to that of the CD10- polytypic B cells, thus higher than the reactive CD10+ GCBCs. This difference was confirmed by immunohistochemical staining. Our results suggest that HLA-DO is a useful marker to differentiate florid follicular hyperplasia from follicular lymphoma by flow cytometry, particularly when clonality of the CD10+ B cells is in question.
HLA - DO的表达在B细胞发育和激活过程中受到调控。为了确定HLA - DO表达水平是否有助于鉴别诊断 florid滤泡增生与滤泡淋巴瘤，我们通过四色流式细胞术分析了29个淋巴结标本的单细胞悬液。在这29个标本中，7个来自florid滤泡增生患者，通过流式细胞术免疫表型分析，生发中心B细胞（GCBCs）的克隆性无法确定。其余22例为滤泡淋巴瘤；其中2例的肿瘤细胞缺乏表面免疫球蛋白轻链表达。与同一标本中的CD10 - 多型性B细胞相比，florid滤泡增生中反应性CD10 + GCBCs的HLA - DO表达水平明显下调。相反，所有滤泡淋巴瘤病例中CD10 + 肿瘤细胞的HLA - DO表达水平与CD10 - 多型性B细胞相似，因此高于反应性CD10 + GCBCs。免疫组织化学染色证实了这种差异。我们的结果表明，HLA - DO是通过流式细胞术区分florid滤泡增生与滤泡淋巴瘤的有用标志物，特别是当CD10 + B细胞的克隆性存在疑问时。
