Zelger B, Cerio R, Soyer H P, Misch K, Orchard G, Wilson-Jones E
Department of Dermatology, University of Innsbruck, Austria.
Am J Dermatopathol. 1994 Dec;16(6):577-84. doi: 10.1097/00000372-199412000-00001.
The clinicopathological and immunohistochemical features of four patients with systemic multicentric reticulohistiocytosis (MR) were compared with five cases of solitary and one case of multiple reticulohistiocytoma (RH), which were confined to the skin only. The MR cases mostly affected the limbs of older women, while RH affected young male adults without preference to site. Characteristically, both entities consisted of oncocytic mononuclear histiocytes (with granular eosinophilic cytoplasm similar to oncocytic thyroid cells) and multinucleated histiocytes with a ground-glass appearance, which appeared to be much larger (> 200 microns) and bizarre in cases of RH compared with cases of MR (50-100 microns). In RH a variable number of vacuolated, spindle-shaped, and xanthomatized mononuclear histiocytes were also present. Immunohistochemical profiles showed positivity of mononuclear histiocytes with HHF35, factor XIIIa, and LN3 (HLA-DR), with a variable number of multinucleated histiocytes in RH showing binding with peanut agglutinin. In mono- and multinucleated histiocytes in both entities macrophage markers KP1 (CD68), KiM1P, HAM56, lysozyme, and alpha 1-antitrypsin were positive. However, macrophage markers MAC387 (L1 antigen) and Leu-M1 (CD15) were negative. Vimentin was universally positive in both conditions, with all other markers (S100, desmin, smooth muscle-specific actin, and QBEnd 10 [CD34]) negative. This study shows that histology supplemented by immunocytochemistry delineates MR from RH and immunohistochemical profiles indicate a cell lineage relationship between RH and adult xanthogranuloma.
将4例系统性多中心网状组织细胞增多症（MR）患者的临床病理和免疫组化特征与5例仅局限于皮肤的孤立性网状组织细胞瘤（RH）及1例多发性网状组织细胞瘤进行了比较。MR病例大多累及老年女性的四肢，而RH累及年轻成年男性，无部位偏好。特征性地，这两种病变均由嗜酸性粒细胞单核组织细胞（具有类似于嗜酸性粒细胞甲状腺细胞的颗粒状嗜酸性细胞质）和具有毛玻璃样外观的多核组织细胞组成，与MR病例（50 - 100微米）相比，RH病例中的多核组织细胞似乎大得多（> 200微米）且形态怪异。在RH中还存在数量不等的空泡化、梭形和黄色瘤样单核组织细胞。免疫组化结果显示单核组织细胞对HHF35、因子XIIIa和LN3（HLA - DR）呈阳性反应，RH中有数量不等的多核组织细胞与花生凝集素结合。在这两种病变的单核和多核组织细胞中，巨噬细胞标志物KP1（CD68）、KiM1P、HAM56、溶菌酶和α1 - 抗胰蛋白酶均为阳性。然而，巨噬细胞标志物MAC387（L1抗原）和Leu - M1（CD15）为阴性。波形蛋白在两种情况下均普遍呈阳性，所有其他标志物（S100、结蛋白、平滑肌特异性肌动蛋白和QBEnd 10 [CD34]）均为阴性。本研究表明，组织学检查辅以免疫细胞化学可将MR与RH区分开来，免疫组化结果表明RH与成人黄色肉芽肿之间存在细胞谱系关系。
