Gould V E, Bloom K J, Franke W W, Warren W H, Moll R
Department of Pathology, Rush Medical College, Chicago, IL 60612-3864.
Virchows Arch. 1995;425(6):617-29. doi: 10.1007/BF00199352.
A total of 291 enlarged lymph nodes showing a range of reactive-inflammatory processes, primary and metastatic neoplasms were studied to determine the distribution and immunoprofile of their cytokeratin-positive interstitial reticulum cells (CIRC) in comparison with normal nodes. In 258/291 nodes (89%), CIRC numbers were distinctly increased in the subcapsular, paracortical and, occasionally, in the medullary zones; often, these increased CIRC formed networks around follicles, sinuses and vessels. CIRC had comparatively small, irregularly shaped bodies and dendritic processes; occasionally, giant forms were noted. CIRC contained cytokeratins (CK) 8 and 18 but not 19, as shown by immunohistochemistry, and by gel electrophoresis with subsequent immunoblotting. They co-expressed vimentin consistently, alpha-smooth-muscle actin frequently, and desmin less frequently. They did not contain desmoplakins, Factor VIII, S-100, LCA, B and T lymphocyte- and macrophage-associated antigens, chromogranin A, synaptophysin or the A-80 glycoprotein. We found no clear correlation between the increased CIRC and given nodal disease processes. However, CIRC were most abundant in nodes free of but draining malignant tumours; bizarre CIRC assemblies were noted in HIV lymphadenopathy. CIRC appear to represent a subset of the so-called "fibroblastic reticulum cells" of lymph nodes. Their function remains undetermined; their increase in diverse lymphadenopathies suggests that they partake in nodal reactions to injury. It remains unclear whether the increase in CIRC relative number is due to proliferation or to CK gene induction processes but their presence and potential capability to undergo hyperplasia with dysplastic forms should alert pathologists to possible diagnostic pitfalls. In addition, we discuss that CIRC may undergo transformation and represent the "cell of origin" of certain CK-positive tumours restricted to lymph nodes.
共研究了291个显示一系列反应性炎症过程、原发性和转移性肿瘤的肿大淋巴结，以确定其细胞角蛋白阳性间质网状细胞（CIRC）与正常淋巴结相比的分布和免疫表型。在258/291个淋巴结（89%）中，被膜下、副皮质区以及偶尔在髓质区的CIRC数量明显增加；通常，这些增多的CIRC在滤泡、窦和血管周围形成网络。CIRC有相对较小、形状不规则的体和树突状突起；偶尔可见巨大形态。免疫组织化学、凝胶电泳及后续免疫印迹显示，CIRC含有细胞角蛋白（CK）8和18，但不含CK19。它们始终共同表达波形蛋白，经常表达α-平滑肌肌动蛋白，较少表达结蛋白。它们不含有桥粒斑蛋白、因子VIII、S-100、白细胞共同抗原、B和T淋巴细胞及巨噬细胞相关抗原、嗜铬粒蛋白A、突触素或A-80糖蛋白。我们发现CIRC增多与特定的淋巴结疾病过程之间没有明显相关性。然而，CIRC在无恶性肿瘤但引流恶性肿瘤的淋巴结中最为丰富；在HIV淋巴结病中可见奇异的CIRC聚集。CIRC似乎代表淋巴结中所谓“成纤维网状细胞”的一个亚群。它们的功能尚不确定；它们在多种淋巴结病中的增多表明它们参与了淋巴结对损伤的反应。目前尚不清楚CIRC相对数量的增加是由于增殖还是CK基因诱导过程，但它们的存在以及发生发育异常形式增生的潜在能力应提醒病理学家注意可能的诊断陷阱。此外，我们讨论了CIRC可能发生转化，并代表某些仅限于淋巴结的CK阳性肿瘤的“起源细胞”。
