van Houte A J, Schuurman H J, Huber J, van der Meer J, van der Vegt J H, Kuis W, Jambroes G, de Weger R A
Department of Pathology, University Hospital, Utrecht, The Netherlands.
Am J Clin Pathol. 1990 Sep;94(3):318-22.
T- and B-lymphocyte populations in peripheral lymphoid tissues occur in distinct compartments (e.g., the periarteriolar lymphocyte sheath of the splenic white pulp is a T-cell area). The authors report on two patients with severe combined immunodeficiency (SCID) and one patient with immunodeficiency after anti-T-cell treatment for rejection of a heart transplant, in which the area surrounding the central arteriole in spleen white pulp was well-populated despite T-cell deficiency (documented by, for example, severe depletion of lymph node paracortex). Immunologic phenotyping showed the B-lymphoid lineage of lymphocytes at this location. The framework in the periarteriolar area consisted of follicular dendritic cells, which are typical framework components of B-cell areas. We conclude that assessment of only conventional histopathology of the spleen in these patients leads to erroneous conclusions about the type of immunodeficiency and that immunologic phenotyping is required to document the exact nature of the deficiency.
外周淋巴组织中的T淋巴细胞和B淋巴细胞群体分布在不同的区域（例如，脾白髓的动脉周围淋巴细胞鞘是一个T细胞区）。作者报告了两名严重联合免疫缺陷（SCID）患者和一名心脏移植排斥反应接受抗T细胞治疗后出现免疫缺陷的患者，尽管存在T细胞缺陷（例如，淋巴结副皮质严重耗竭证明），但脾白髓中央小动脉周围区域仍有大量细胞。免疫表型分析显示该位置的淋巴细胞为B淋巴细胞谱系。动脉周围区域的支架由滤泡树突状细胞组成，这是B细胞区典型的支架成分。我们得出结论，仅对这些患者的脾脏进行传统组织病理学评估会导致关于免疫缺陷类型的错误结论，需要进行免疫表型分析来记录缺陷的确切性质。
