Wang T, Lasota J, Hanau C A, Miettinen M
Department of Anatomy, Pathology and Cell Biology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
APMIS. 1995 Sep;103(9):655-62. doi: 10.1111/j.1699-0463.1995.tb01419.x.
The distribution of Bcl-2 oncoprotein was studied immunohistochemically in formaldehyde-fixed and paraffin-embedded reactive and neoplastic lymphoid tissue. The potential of Bcl-2 for the differential diagnosis of follicular lesions was emphasized, and the results on follicular lesions were correlated with those of polymerase chain reaction (PCR) assay of the immunoglobulin heavy chain gene rearrangement. In hyperplastic lymphoid tissue, Bcl-2 reactivity was widespread, including germinal center surroundings, scattered cells within the germinal centers, and the T-cell areas in general. Distinctively negative lymphoid populations included the majority of germinal center cells, and the negative staining pattern was maintained in cases of florid hyperplasia. In contrast, follicular lymphoma cells were consistently Bcl-2 positive. The immunohistochemical Bcl-2 reactivity of lymphoma follicles correlated with the clonal PCR amplification pattern of the immunoglobulin heavy chain gene; all Bcl-2-negative hyperplasias revealed a non-clonal pattern. Clusters of monocytoid B cells were Bcl-2 negative, whereas monocytoid B-cell lymphomas and closely related MALT lymphomas were positive. All other small cell non-Hodgkin's lymphomas of B-cell types showed nearly uniform Bcl-2 reactivity, whereas large cell B-cell lymphomas were variably positive (74%). In Hodgkin's cells, Bcl-2 reactivity was seen in the neoplastic populations of most cases of nodular sclerosis and mixed cellularity types, whereas the L&H and Reed-Sternberg cells in lymphocyte predominance Hodgkin's disease were negative in most cases. Bcl-2 immunohistochemistry thus appears very valuable in the differential diagnosis of follicular hyperplasia and neoplasia, and it may help to distinguish between reactive and neoplastic monocytoid B cells. However, Bcl-2 immunohistochemistry is not useful in the subtyping of B-cell lymphomas.
采用免疫组织化学方法研究了甲醛固定、石蜡包埋的反应性和肿瘤性淋巴组织中Bcl-2癌蛋白的分布。强调了Bcl-2在滤泡性病变鉴别诊断中的作用，并将滤泡性病变的结果与免疫球蛋白重链基因重排的聚合酶链反应（PCR）检测结果进行了关联。在增生性淋巴组织中，Bcl-2反应广泛存在，包括生发中心周围、生发中心内散在的细胞以及一般的T细胞区。明显阴性的淋巴细胞群体包括大多数生发中心细胞，在 florid增生病例中保持阴性染色模式。相比之下，滤泡性淋巴瘤细胞始终呈Bcl-2阳性。淋巴瘤滤泡的免疫组织化学Bcl-2反应性与免疫球蛋白重链基因的克隆性PCR扩增模式相关；所有Bcl-2阴性增生均显示非克隆模式。单核样B细胞簇为Bcl-2阴性，而单核样B细胞淋巴瘤和密切相关的MALT淋巴瘤为阳性。所有其他B细胞型小细胞非霍奇金淋巴瘤显示出几乎一致的Bcl-2反应性，而大细胞B细胞淋巴瘤则呈不同程度的阳性（74%）。在霍奇金细胞中，大多数结节硬化型和混合细胞型病例的肿瘤细胞群体中可见Bcl-2反应性，而淋巴细胞为主型霍奇金病中的L&H和里德-斯腾伯格细胞在大多数情况下为阴性。因此，Bcl-2免疫组织化学在滤泡增生和肿瘤的鉴别诊断中似乎非常有价值，并且可能有助于区分反应性和肿瘤性单核样B细胞。然而，Bcl-2免疫组织化学在B细胞淋巴瘤的亚型分类中并无用处。
