Medeiros L J, Picker L J, Abel E A, Hu C H, Hoppe R T, Warnke R A, Wood G S
Department of Pathology, Stanford University Medical Center, Palo Alto, CA.
J Am Acad Dermatol. 1989 Nov;21(5 Pt 1):929-42.
Fifteen cases of cutaneous lymphoid hyperplasia were studied immunohistologically with a large panel of monoclonal antibodies to determine their immunoarchitectural composition and to determine whether immunologic criteria recently proposed to identify lymphoma ever occur in benign skin lesions. All lesions were composed of T cells, polytypic B cells, macrophages, and Langerhans cells. Although only six cases containing lymphoid follicles were recognized in routinely stained sections, an additional five were identified in immunoperoxidase-stained sections. These follicles were of both the primary and secondary types and contained dendritic reticulum cell networks. The immunophenotypic features of these follicles were similar to those of reactive follicles in lymphoid organs and contrasted sharply with those reported previously for follicular lymphomas. Helper T cells were predominant in 11 cases. With regard to proposed criteria for T cell lymphoma, we did not detect loss of pan T cell antigens CD2, CD3, CD5, or BF-1, nor did we find populations of T cells with abnormal co-expression or loss of subset antigens such as CD4-8- or CD4+8+. Two cases in which relatively sparse infiltrates were present, however, were moderately CD7-deficient. This finding suggests that the CD7 criterion for cutaneous T cell neoplasia be modified in this situation. As observed previously, Leu-8 antigen deficiency was a common, nonspecific finding. With regard to proposed criteria for B cell lymphoma, we did not detect populations of B cells that were immunoglobulin-negative, nor did we observe preferential loss of one or more B-lineage antigens, histocompatibility complex-associated antigens, or lymphocyte function-associated antigens. We also did not identify any CD5+ B cells. On the basis of a comparison of our current data with prior studies of cutaneous lymphomas, we conclude that the immunologic findings recently proposed as general criteria for the differentiation of lymphoma from lymphoid hyperplasia are, in fact, applicable to cutaneous lymphoid lesions.
对15例皮肤淋巴细胞增生症进行了免疫组织学研究，使用大量单克隆抗体来确定其免疫结构组成，并确定最近提出的用于识别淋巴瘤的免疫标准是否会出现在良性皮肤病变中。所有病变均由T细胞、多型性B细胞、巨噬细胞和朗格汉斯细胞组成。虽然在常规染色切片中仅识别出6例含有淋巴滤泡的病例，但在免疫过氧化物酶染色切片中又发现了5例。这些滤泡有原发性和继发性两种类型，并含有树突状网状细胞网络。这些滤泡的免疫表型特征与淋巴器官中的反应性滤泡相似，与先前报道的滤泡性淋巴瘤形成鲜明对比。11例中辅助性T细胞占主导。关于T细胞淋巴瘤的既定标准，我们未检测到泛T细胞抗原CD2、CD3、CD5或BF-1的缺失，也未发现T细胞群体存在异常共表达或亚群抗原如CD4-8-或CD4+8+的缺失。然而，有2例浸润相对稀疏的病例存在中度CD7缺陷。这一发现表明，在这种情况下，皮肤T细胞肿瘤的CD7标准应予以修正。如先前观察到的，Leu-8抗原缺陷是一个常见的非特异性发现。关于B细胞淋巴瘤既定标准方面，我们未检测到免疫球蛋白阴性的B细胞群体，也未观察到一种或多种B谱系抗原、组织相容性复合体相关抗原或淋巴细胞功能相关抗原的优先缺失。我们也未识别出任何CD5+B细胞。基于将我们目前的数据与先前皮肤淋巴瘤研究进行比较，我们得出结论，最近提出的作为区分淋巴瘤与淋巴细胞增生症一般标准的免疫发现，实际上适用于皮肤淋巴细胞病变。
