Weiss Lawrence M, Loera Sofia, Bacchi Carlos E
Division of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA.
Appl Immunohistochem Mol Morphol. 2010 May;18(3):199-205. doi: 10.1097/PAI.0b013e3181c59a81.
The identification of monotypic light chains is an important adjunct to the diagnosis of B-cell lymphoma, yet to reliably perform it on formalin-fixed paraffin sections is often difficult. We have evaluated a new set of monoclonal antibodies to kappa and lambda light chains that are reactive in paraffin sections. In reactive lymphoid tissues, polytypic staining was noted in greater than 95% of cases, with strong staining of plasma cells, moderate staining of the follicular dendritic cell network, and weak staining of mantle zone cells. Strong staining of the appropriate light chain was seen in each of the 7 cases of multiple myeloma. In a series of 58 cases of B-cell lymphoma, correlation between the results of immunohistochemistry and flow cytometry was obtained in 36 cases (62%), including 32 cases (21 kappa and 11 lambda) in which a single light chain was expressed. Monotypic staining was also seen in 6 additional cases (10%) in which flow cytometry was negative. Thirty of 46 cases (65%) of follicular lymphoma showed monotypic light chain expression, in contrast to 64 of 67 cases (95%) of reactive lymphoid hyperplasia, which showed polytypic light chain expression. These antibodies may provide an effective adjunct to the diagnosis of B-cell lymphoma in routine diagnostic work.
单型轻链的鉴定是B细胞淋巴瘤诊断的重要辅助手段，但要在福尔马林固定石蜡切片上可靠地进行鉴定往往很困难。我们评估了一组新的针对κ和λ轻链的单克隆抗体，它们在石蜡切片中具有反应性。在反应性淋巴组织中，超过95%的病例呈现多型性染色，浆细胞呈强染色，滤泡树突状细胞网络呈中度染色，套区细胞呈弱染色。7例多发性骨髓瘤病例均可见相应轻链的强染色。在一系列58例B细胞淋巴瘤病例中，36例（62%）免疫组化结果与流式细胞术结果具有相关性，其中32例（κ型21例，λ型11例）表达单一轻链。另外6例（10%）流式细胞术结果为阴性的病例也可见单型性染色。46例滤泡性淋巴瘤中有30例（65%）显示单型轻链表达，而67例反应性淋巴组织增生中有64例（95%）显示多型性轻链表达。这些抗体可为常规诊断工作中B细胞淋巴瘤的诊断提供有效的辅助手段。
