Dermatology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Dermatology, Beijing Chaoyang Hospital Jingxi Branch, Beijing, China.
J Clin Pathol. 2022 Sep;75(9):627-631. doi: 10.1136/jclinpath-2021-207443. Epub 2021 May 5.
Clear cells formed due to depositions of glycogen or lipids in the cytoplasm commonly occur in various tissues. Adipophilin (ADP), a lipid regulatory protein, is closely related to lipid droplets. This study aims to examine adipophilin expression in clear cells of various skin lesions.
ADP expression was examined using immunohistochemistry in 108 sections from 15 skin lesion types with clear cell histology, namely, sebaceoma (n=16), sebaceous adenoma (n=3), sebaceous carcinoma (n=12), xanthomata cutis (n=10), xanthogranuloma (n=8), Paget's disease (n=10), Bowen disease (n=10), hidradenoma (n=9), atypical lipoma (n=5), superficial lipomatous nevus (n=5), metastatic renal cell carcinoma (n=5), squamous cell carcinoma (n=4), seborrheic keratosis (n=4), dermatofibroma (n=4) and clear cell sarcoma (n=3).
ADP was not expressed in Bowen disease, hidradenoma or seborrheic keratosis. Four expression patterns, foamy, reticular, granular and punctate, were summarised based on their expression in clear cells. Different expression patterns were related to tissue origin and differentiation degree. Foamy expression was commonly observed in lesions with mature sebaceous glands and xanthomas; reticular expression in adipocytes; granular expression in xanthoma, xanthogranuloma and metastatic renal carcinoma and punctate expression in sebaceoma, sebaceous carcinoma, Paget's disease, squamous cell carcinoma and clear cell sarcoma. Furthermore, stronger staining with focal vesicular labelling was noted in sebaceoma than in sebaceous carcinoma. Characteristic labelling was noted, including the circular distribution in Touton giant cells of xanthogranulomas and focal distribution in the clear cells along the edge of necrotic tissue in clear cell sarcoma.
ADP is useful in identifying intracytoplasmic lipids and can be used to diagnose skin lesions with clear cell histology, especially in some lesions with characteristic labelling.
细胞质中糖原或脂质的沉积常导致各种组织中出现透明细胞。脂滴调节蛋白脂肪素（ADP）与脂质滴密切相关。本研究旨在探讨不同皮肤病变透明细胞中脂肪素的表达。
采用免疫组织化学方法，对 15 种具有透明细胞组织学特征的皮肤病变组织（包括皮脂腺瘤 16 例、皮脂腺腺瘤 3 例、皮脂腺癌 12 例、皮肤黄色瘤 10 例、黄色瘤 8 例、Paget 病 10 例、 Bowen 病 10 例、汗腺瘤 9 例、非典型脂肪瘤 5 例、浅表脂肪瘤样痣 5 例、转移性肾细胞癌 5 例、鳞状细胞癌 4 例、脂溢性角化病 4 例、纤维组织细胞瘤 4 例和透明细胞肉瘤 3 例）的 108 个切片进行 ADP 表达检测。
Bowen 病、汗腺瘤或脂溢性角化病中不表达 ADP。根据透明细胞中的表达，总结了 4 种表达模式：泡沫状、网状、颗粒状和点状。不同的表达模式与组织起源和分化程度有关。泡沫状表达常见于成熟的皮脂腺和黄色瘤；网状表达见于脂肪细胞；颗粒状表达见于黄色瘤、黄色瘤性肉芽肿和转移性肾细胞癌；点状表达见于皮脂腺瘤、皮脂腺癌、Paget 病、鳞状细胞癌和透明细胞肉瘤。此外，在皮脂腺瘤中观察到比在皮脂腺癌中更强的点状局灶性囊泡样染色。还观察到特征性染色，包括黄色瘤性肉芽肿中的 Touton 巨细胞的环状分布和透明细胞肉瘤中沿坏死组织边缘的透明细胞的局灶性分布。
ADP 有助于识别细胞内脂质，可用于诊断具有透明细胞组织学特征的皮肤病变，特别是在一些具有特征性染色的病变中。
