Spina D, Miracco C, Santopietro R, Sforza V, Leoncini L, Pacenti L, Lio R, Luzi P, Tosi P, Kraft R
Institute of Pathologic Anatomy and Histology, University of Siena, Italy.
Am J Dermatopathol. 1993 Oct;15(5):415-22. doi: 10.1097/00000372-199310000-00001.
The difficult differential diagnosis between the diffuse variants of cutaneous lymphoid hyperplasia (CLH; synonym; pseudolymphoma) and malignant follicular center cell lymphomas (FCCL) often requires a multidisciplinary approach. Eighteen CLH and 11 FCCL, diagnosed by conventional histology and immunophenotyping and subsequently examined with a polymerase chain reaction to show clonal immunoglobulin heavy-chain gene rearrangements, were subjected to a novel type of automated nuclear image analysis. Of all nuclear parameters tested in azure A-stained semithin sections, the mean nuclear profile area (TN) of lymphoid cells was the best criterion to distinguish between CLH and FCCL (p = 9 x 10(-6)). Additional distinctive features, in the order of decreasing significance, were the SD of TN; all chromatin textural parameters combined; and the light and the dark fractions of the central nuclear profile areas. Parameters related to the chromatin pattern were independent of nuclear profile size in FCCL, but not in CLH. Two lesions registered as CLH displayed the nuclear characteristics favoring this diagnosis, but showed B-cell monoclonality at the DNA level. In conclusion, computerized nuclear image analysis is a helpful additional diagnostic tool in the evaluation of diffuse CLH and cutaneous FCCL.
皮肤淋巴细胞增生症（CLH；同义词：假性淋巴瘤）的弥漫性变种与恶性滤泡中心细胞淋巴瘤（FCCL）之间的鉴别诊断颇具难度，通常需要多学科方法。对18例经传统组织学和免疫表型分析诊断，并随后通过聚合酶链反应检测以显示克隆性免疫球蛋白重链基因重排的CLH和11例FCCL进行了一种新型的自动核图像分析。在天青A染色的半薄切片中检测的所有核参数中，淋巴细胞的平均核轮廓面积（TN）是区分CLH和FCCL的最佳标准（p = 9×10⁻⁶）。按重要性递减顺序排列的其他显著特征包括TN的标准差；所有染色质纹理参数的总和；以及中央核轮廓区域的亮区和暗区。与染色质模式相关的参数在FCCL中与核轮廓大小无关，但在CLH中并非如此。有两个病变被诊断为CLH，其核特征支持该诊断，但在DNA水平显示B细胞单克隆性。总之，计算机化核图像分析是评估弥漫性CLH和皮肤FCCL的一种有用的辅助诊断工具。
