Olsen Stephen H, Ma Linglei, Schnitzer Bertram, Fullen Douglas R
Department of Pathology, University of Michigan Medical Center, Ann Arbor, MI 48109-0602, USA.
J Cutan Pathol. 2009 Mar;36(3):302-7. doi: 10.1111/j.1600-0560.2008.01036.x.
Clusterin is a ubiquitous 80 kDa heterodimeric glycoprotein previously shown to be expressed on tumor cells of systemic and, to a lesser extent, primary cutaneous anaplastic large cell lymphoma (PC-ALCL). Lymphomatoid papulosis (LyP), an important differential diagnosis of ALCL, has been studied for clusterin expression in only a small number of cases. The aim of this study was to compare clusterin immunostaining patterns in LyP and other cutaneous histologic simulants with those of PC-ALCL.
Formalin-fixed, paraffin-embedded sections of PC-ALCL (6), LyP (20), mycosis fungoides with large cell transformation (MF-LCT, 12), pityriasis lichenoides et varioliformis acuta (PLEVA, 12), arthropod bite reaction (ABR, 12) and lymphomatoid reactions (LR, 9) were immunostained for clusterin and evaluated for staining pattern and distribution. All diagnoses were made with clinicopathologic correlation.
Characteristic dot-like Golgi staining was identified in 10/20 LyP (50%), 4/6 PC-ALCL (67%) and 9/12 MF-LCT (75%). Two of 12 PLEVA (17%), 1 of 12 ABR (8%) and 2 of 8 LR (25%) had lymphocytes (< 25%) with diffuse cytoplasmic staining. Dermal dendritic cells stained strongly for clusterin. High background staining occurred in some cases.
Clusterin immunostaining does not reliably distinguish between LyP, PC-ALCL or MF-LCT, but could distinguish LyP from its reactive histologic simulants.
簇集素是一种普遍存在的80 kDa异二聚体糖蛋白，先前已证明其在系统性肿瘤细胞上表达，在原发性皮肤间变性大细胞淋巴瘤（PC-ALCL）中表达程度较低。淋巴瘤样丘疹病（LyP）是ALCL的重要鉴别诊断疾病，仅在少数病例中研究了其簇集素表达情况。本研究的目的是比较LyP和其他皮肤组织学模拟病变中簇集素免疫染色模式与PC-ALCL中的模式。
对PC-ALCL（6例）、LyP（20例）、蕈样肉芽肿伴大细胞转化（MF-LCT，12例）、急性痘疮样苔藓样糠疹（PLEVA，12例）、节肢动物叮咬反应（ABR，12例）和淋巴瘤样反应（LR，9例）的福尔马林固定、石蜡包埋切片进行簇集素免疫染色，并评估染色模式和分布。所有诊断均结合临床病理相关性做出。
在10/20例LyP（50%）、4/6例PC-ALCL（67%）和9/12例MF-LCT（75%）中发现特征性的点状高尔基体染色。12例PLEVA中有2例（17%）、12例ABR中有1例（8%）以及8例LR中有2例（25%）的淋巴细胞（<25%）出现弥漫性细胞质染色。真皮树突状细胞簇集素染色强烈。部分病例出现高背景染色。
簇集素免疫染色不能可靠地区分LyP、PC-ALCL或MF-LCT，但可将LyP与其反应性组织学模拟病变区分开来。
