Tubbs R R, Savage R A, Crabtree R H, Sebek B A, Valenzuela R, Benjamin S P
Am J Clin Pathol. 1979 Nov;72(5):789-94. doi: 10.1093/ajcp/72.5.789.
The diagnosis of malignant histiocytosis is usually based upon typical light microscopic features of the neoplasm. Supplementary cytochemical and immunologic features have been suggested as typical of malignant histiocytosis. The present study was prompted by an unusual erythropagocytic hepatocellular carcinoma having immunologic and cytochemical markers suggesting mononuclear phagocytic origin. Twenty-four neoplasms of unquestionable epithelial origin were prospectively evaluated for activity of alpha-naphthyl acetate esterase, a cytochemical marker useful in distinguishing between the non-Hodgkin's lymphomas and malignant histiocytosis. The epithelial tumors represented a broad spectrum of tissue origins and consistently demonstrated alpha-naphthyl acetate esterase activity. Thus, erythrophagocytosis and alpha-naphthyl acetate esterase positivity may be misleading in the unusual instance in which the histopathologic differential diagnosis includes malignant histiocytosis and epithelial neoplasia. Ultrastructural assessment is useful in the exclusion of poorly differentiated carcinoma.
恶性组织细胞增多症的诊断通常基于肿瘤典型的光镜特征。补充的细胞化学和免疫学特征也被认为是恶性组织细胞增多症的典型表现。本研究源于一例不寻常的具有免疫和细胞化学标记提示单核吞噬细胞起源的噬红细胞性肝细胞癌。前瞻性评估了24例明确上皮起源的肿瘤的α-萘乙酸酯酶活性，该细胞化学标记物有助于区分非霍奇金淋巴瘤和恶性组织细胞增多症。上皮性肿瘤代表了广泛的组织起源，且始终表现出α-萘乙酸酯酶活性。因此，在组织病理学鉴别诊断包括恶性组织细胞增多症和上皮性肿瘤的不寻常情况下，噬红细胞现象和α-萘乙酸酯酶阳性可能会产生误导。超微结构评估有助于排除低分化癌。
