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CXCL13、CD10和bcl-6在血管免疫母细胞性T细胞淋巴瘤及外周T细胞淋巴瘤(非特殊类型)中的表达

[Expressions of CXCL13, CD10 and bcl-6 in angioimmunoblastic T-cell lymphoma and peripheral T-cell lymphoma, not otherwise specified].

作者信息

Tang Xue-feng, Li Gan-di, Li Ya-lin, Liang Dong-ni, Xia Tian, Zhou Ji-yong, Yao Yu-qi, Wu Wen-qiao, Wang Zhan-gui, Yang Yong-hong, Tang Xian-bin, Bai Yan-qiong, Ding Qiang

机构信息

Department of Pathology, West China Hospital of Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2009 Apr;38(4):224-30.

Abstract

OBJECTIVE

To study the value of immunomarkers CXCL13, CD10, bcl-6 in pathologic diagnosis of angioimmunoblastic T-cell lymphoma (AITL).

METHODS

One hundred and fifteen cases of AITL, 30 cases of peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) and 30 cases of reactive lymph nodes with paracortical hyperplasia (RH) encountered during the period from January, 1990 to January, 2008 were retrieved from the archival files of the Department of Pathology, West China Hospital of Sichuan University, China. The morphologic features were reviewed and compared. Immunohistochemical study was performed by SP method for CXCL13, CD10, bcl-6, CD21, CD3epsilon, CD3, CD45RO, CD20 and Ki-67. TCR-gamma gene rearrangement study was also carried out.

RESULTS

Regressed follicles were evident in 7.8% (9/115) of AITL cases, 6.7% (2/30) of PTCL, NOS cases and 83.3% (25/30) of RH cases, respectively. A marked increase of number of arborizing venules was shown in 98.3% (113/115) of AITL cases, 63.3% (19/30) of PTCL, NOS cases and 76.7% (23/30) of RH cases, respectively. In lymph nodes with paracortical hyperplasia, the expression of CXCL13, CD10 and bcl-6 were restricted to the germinal centers. In AITL, 96.5% (111/115) of cases showed CXCL13 expression, in contrast to 26.7% (8/30) of PTCL, NOS. Expression of CD10 and bcl-6 were found in the neoplastic cells in 50.4% (58/115) and 78.3% (90/115) of AITL, and 3.3% (1/30) and 3.3% (1/30) of PTCL, NOS, respectively. Irregular meshworks of CD21-positive follicular dendritic cells were found in all the AITL cases. Clonal TCR-gamma rearrangement was detected in 83% (83/100) of the AITL cases.

CONCLUSIONS

AITL is a type of lymphoma originated from the follicular helper T cells. Detailed morphologic assessment and use of immunohistochemical markers are essential for accurate diagnosis.

摘要

目的

研究免疫标志物CXCL13、CD10、bcl-6在血管免疫母细胞性T细胞淋巴瘤(AITL)病理诊断中的价值。

方法

从四川大学华西医院病理科1990年1月至2008年1月存档文件中检索出115例AITL、30例外周T细胞淋巴瘤,非特指型(PTCL,NOS)及30例伴有副皮质区增生(RH)的反应性淋巴结病例。回顾并比较其形态学特征。采用SP法对CXCL13、CD10、bcl-6、CD21、CD3ε、CD3、CD45RO、CD20及Ki-67进行免疫组化研究。同时进行TCR-γ基因重排研究。

结果

分别有7.8%(9/115)的AITL病例、6.7%(2/30)的PTCL,NOS病例及83.3%(25/30)的RH病例可见退化滤泡。分别有98.3%(113/115)的AITL病例、63.3%(19/30)的PTCL,NOS病例及76.7%(23/30)的RH病例显示树枝状小静脉数量明显增加。在伴有副皮质区增生的淋巴结中,CXCL13、CD10及bcl-6的表达局限于生发中心。在AITL中,96.5%(111/115)的病例显示CXCL13表达阳性,而PTCL,NOS病例中为26.7%(8/30)。在AITL中,分别有50.4%(58/115)和78.3%(90/115)的肿瘤细胞表达CD10和bcl-6,而在PTCL,NOS中分别为3.3%(1/30)和3.3%(1/30)。所有AITL病例均可见CD21阳性滤泡树突状细胞的不规则网状结构。在83%(83/100)的AITL病例中检测到克隆性TCR-γ重排。

结论

AITL是一种起源于滤泡辅助性T细胞的淋巴瘤。详细的形态学评估及免疫组化标志物的应用对准确诊断至关重要。

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