Department of Pathology, National Cheng Kung University and Hospital, Tainan, Taiwan.
Histopathology. 2012 Nov;61(5):974-83. doi: 10.1111/j.1365-2559.2012.04282.x. Epub 2012 Jul 17.
Proliferation of plasmacytoid dendritic cells (PDCs) occurs in both reactive lymphoid hyperplasia and myeloproliferative disorders, especially chronic myelomonocytic leukaemia. PDCs in the former appear reactive, but in the latter are reported to be clonally related to the underlying myeloid neoplasm. Langerhans cells (LCs), another type of dendritic cell, also proliferate in both reactive dermatoses and, rarely, myeloproliferative disorders, such as acute leukaemia.
We report a rare case of tumorous proliferation of PDCs and LCs in the systemic lymph nodes in a 55-year-old man with acute myeloid leukaemia. A microsatellite instability assay showed identical patterns of short tandem repeats in both microdissected PDC and LC components, along with blood blasts.
We hypothesize that the combined proliferations of PDCs and LCs derive from the same haematopoietic stem cells, but that they differentiate divergently under the effect of different microenvironments.
浆细胞样树突状细胞(PDC)在反应性淋巴组织增生和骨髓增生性疾病中均有增殖,尤其是慢性髓单核细胞白血病。前者的 PDC 表现为反应性,但后者报道称与潜在的髓系肿瘤克隆相关。朗格汉斯细胞(LC)是另一种树突状细胞,也在反应性皮肤病和骨髓增生性疾病(如急性白血病)中增殖。
我们报告了一例 55 岁男性急性髓系白血病患者全身淋巴结中 PDC 和 LC 肿瘤性增殖的罕见病例。微卫星不稳定性检测显示,微切割的 PDC 和 LC 成分以及血液母细胞均具有相同的短串联重复模式。
我们假设 PDC 和 LC 的联合增殖来自于同一造血干细胞,但在不同微环境的影响下,它们分化为不同的细胞。