Ritter J H, Goldstein N S, Argenyi Z, Wick M R
Division of Surgical Pathology, Barnes Hospital, Washington University Medical Center, St. Louis, Missouri 63110.
J Cutan Pathol. 1994 Jun;21(3):207-16. doi: 10.1111/j.1600-0560.1994.tb00262.x.
In evaluating histologically malignant infiltrates in the skin, it is often challenging to distinguish granulocytic sarcoma (GS) from selected cases of peripheral T-cell lymphoma (PTCL). These lesions have clinical features in common, in addition to shared histologic attributes. These include similarity in dermal distribution and growth pattern, nuclear characteristics, propensity to recruit other inflammatory cell types, and production of matrical sclerosis. In order to determine if immunohistology could contribute to differential diagnosis in this setting, we analyzed 15 cases of mucocutaneous GS, and compared them with 11 cases of well-documented PTCL. Antibodies in the CD15, CD20, CD34, CD43, CD45, CD45RO, and CD68 groups were used, as well as anti-myeloperoxidase (anti-MPX), anti-lysozyme (anti-LYSO), Mac387, and MB2. Anti-LYSO and anti-MPX were sensitive and specific markers of GS, labeling 93% and 80% of GS cases, respectively, and no cases of PTCL. Anti-CD15 and MB2 were also specific for GS, but each labeled only 60% of GS cases. CD34, CD68, and Mac 387 were specific but insensitive markers of GS. CD43 and CD45 were not particularly useful discriminants, with each being seen in 93% of GS cases, but also 64% and 100% of cases of PTCL, respectively. CD45RO was specific for PTCL; it was present in 82% of PTCL cases and no GS cases. Thus, conjoint reactivity for CD43, CD45, MPX, and LYSO characterizes GS, and differs from the pattern of PTCL, which is characterized by reactivity for CD45 and CD45RO, occasional reactivity for CD43, and lack of other specified markers.
在评估皮肤组织学上的恶性浸润时，区分粒细胞肉瘤（GS）和某些外周T细胞淋巴瘤（PTCL）病例往往具有挑战性。这些病变除了具有共同的组织学特征外，还具有一些共同的临床特征。这些特征包括真皮分布和生长模式的相似性、核特征、募集其他炎症细胞类型的倾向以及基质硬化的形成。为了确定免疫组织化学在这种情况下是否有助于鉴别诊断，我们分析了15例黏膜皮肤型GS，并将其与11例有充分记录的PTCL病例进行了比较。使用了CD15、CD20、CD34、CD43、CD45、CD45RO和CD68组的抗体，以及抗髓过氧化物酶（抗MPX）、抗溶菌酶（抗LYSO）、Mac387和MB2。抗LYSO和抗MPX是GS的敏感和特异性标志物，分别标记了93%和80%的GS病例，而PTCL病例均未标记。抗CD15和MB2对GS也具有特异性，但各自仅标记了60%的GS病例。CD34、CD68和Mac 387是GS的特异性但不敏感的标志物。CD43和CD45不是特别有用的鉴别指标，分别在93%的GS病例中出现，但也分别在64%和100%的PTCL病例中出现。CD45RO对PTCL具有特异性；它存在于82%的PTCL病例中，而GS病例中均未出现。因此，CD43、CD45、MPX和LYSO的联合反应性是GS的特征，与PTCL的模式不同，PTCL的特征是对CD45和CD45RO有反应，偶尔对CD43有反应，且缺乏其他特定标志物。
