Meister P, Huhn D, Nathrath W
Virchows Arch A Pathol Anat Histol. 1980;385(2):233-46. doi: 10.1007/BF00427407.
Clinically, malignant histiocytosis is a malignant neoplasia with poor prognosis. Diseased are lymphnodes (especially cervical nodes), liver, spleen and bones. Few cases become leukemic. The cells show characteristic pale roundish, often indented nuclei, without large nucleoli and with abundant ill-defined cytoplasm. Phagocytosis of erythrocytes and leukocytes, as well as, hemosiderin deposits may serve as indicators for histiocytic, respectively macrophagic qualities. On touch preparation, tumor cells previously had been marked by acid phosphatase and non-spevific esterase, as being histiocytic. - A comparable marking could be carried out on paraffin embedded material with lysozyme (muramidase) and alpha1-antichymotrypsin, by the indirect immuno-peroxidase technique. No correlation could be proven between any special shape of tumor cells or between different grades of cellular atypism and presence or absence of the immunohistochemical reaction. The reaction with lysozyme and alpha1-antichymotrypsin was also tested in other tumors and was found to be positive in a variety of different tumor cells showing degenerative changes, respectively necrobiosis. - But lysozyme and alpha1-antichymotrypsin are markers characteristically found in histiocytes, respectively histiocytic tumor cells. They are apparently less distinct in MH with a larger number of immature histiocytic tumor cells.
临床上,恶性组织细胞增多症是一种预后不良的恶性肿瘤。病变部位为淋巴结(尤其是颈部淋巴结)、肝脏、脾脏和骨骼。少数病例会发展为白血病。细胞呈现特征性的淡圆形,核常呈凹陷状,无大核仁,胞质丰富且界限不清。红细胞和白细胞的吞噬作用以及含铁血黄素沉积分别可作为组织细胞或巨噬细胞性质的指标。在触片上,肿瘤细胞以前曾通过酸性磷酸酶和非特异性酯酶标记为组织细胞性。 - 对于石蜡包埋材料,可通过间接免疫过氧化物酶技术用溶菌酶(胞壁质酶)和α1 - 抗糜蛋白酶进行类似标记。在肿瘤细胞的任何特殊形态之间,或在不同程度的细胞异型性与免疫组化反应的有无之间,均未证实存在相关性。在其他肿瘤中也检测了与溶菌酶和α1 - 抗糜蛋白酶的反应,发现在各种显示退行性改变或坏死的不同肿瘤细胞中呈阳性。 - 但溶菌酶和α1 - 抗糜蛋白酶分别是在组织细胞或组织细胞性肿瘤细胞中典型发现的标志物。在具有大量未成熟组织细胞性肿瘤细胞的恶性组织细胞增多症中,它们显然不太明显。