Kreft A, Büsche G, Bernhards J, Georgii A
Pathologisches Institut, Medizinische Hochschule Hannover, Germany.
Histopathology. 1997 Feb;30(2):145-51. doi: 10.1046/j.1365-2559.1997.d01-581.x.
Hairy-cell leukaemia may be difficult to diagnose in bone marrow biopsies, especially in the early stages or in its residum after complete clinical remission. To consider the impact of published data on immunophenotyping hairy-cell leukaemias, a total of 50 diagnostic biopsies were systematically analysed with a panel of eight antibodies and compared with cases of chronic lymphatic leukaemia (CLL), 20 follicular centre lymphomas, 20 lympho-plasmacytoid immunocytomas, 10 small-cell T-cell non-Hodgkin lymphomas and 20 cases of benign nodular lymphatic hyperplasia. The panel of eight antibodies comprised DBA44, CD45, CD20, CD45R, CD45RO, CD43 and the CD68 antibodies KP1 and Ki-M1P. The hairy-cell leukaemias were staged histologically into four categories of bone marrow infiltration. DBA44 reacted positively in 47/50 cases. CD45 and the B-cell markers CD20 and CD45R reacted in 49/50 and 43/50 cases, respectively. One CD68 marker, KP1, was positive in 38/50 cases but the other-Ki-M1P-only in 1/50 cases. Chronic lymphatic leukaemia cases, the other B-cell NHLs and lymphatic hyperplasias showed strong positivity for CD20 and CD45R, but only the immunocytomas reacted with DBA44 in 7/20 cases. The T-cell NHLs and hyperplasias showed a strong positivity for the T-cell markers CD45RO and CD43. The CD68-marker Ki-M1P revealed a high specificity since it was negative in all NHLs and positive only in one hairy-cell leukaemia. Methyl-methacrylate embedding of bone marrow biopsies under cold polymerization produces a high quality of histo- and cytomorphology, resulting in greater diagnostic reliability and the detection of low-stage infiltration of hairy-cell leukaemia. DBA44 appears as a highly specific antibody to mark hairy-cells since only immunocytomas reacted positively in a few cases. A small panel of antibodies including DBA44. CD20, CD45R and Ki-M1P may serve to distinguish small-cell. NHL from hairy-cell leukaemia even at an early stage or when there are minimal residual tumour cells.
毛细胞白血病在骨髓活检中可能难以诊断，尤其是在早期阶段或完全临床缓解后的残留期。为了考量已发表数据对毛细胞白血病免疫表型分析的影响，我们使用一组8种抗体对50例诊断性活检样本进行了系统分析，并与慢性淋巴细胞白血病（CLL）、20例滤泡中心淋巴瘤、20例淋巴浆细胞样免疫细胞瘤、10例小细胞T细胞非霍奇金淋巴瘤以及20例良性结节性淋巴增生病例进行了比较。这组8种抗体包括DBA44、CD45、CD20、CD45R、CD45RO, CD43以及CD68抗体KP1和Ki-M1P。毛细胞白血病在组织学上被分为四类骨髓浸润情况。DBA44在47/50例病例中呈阳性反应。CD45以及B细胞标志物CD20和CD45R分别在49/50例和43/50例病例中呈阳性反应。一种CD68标志物KP1在38/50例病例中呈阳性，但另一种Ki-M1P仅在1/50例病例中呈阳性。慢性淋巴细胞白血病病例、其他B细胞非霍奇金淋巴瘤以及淋巴增生病例中，CD20和CD45R呈强阳性，但只有免疫细胞瘤在7/20例病例中与DBA44发生反应。T细胞非霍奇金淋巴瘤和增生病例中，T细胞标志物CD45RO和CD43呈强阳性。CD68标志物Ki-M1P具有高特异性，因为它在所有非霍奇金淋巴瘤中均为阴性，仅在一例毛细胞白血病中呈阳性。在冷聚合条件下对骨髓活检样本进行甲基丙烯酸甲酯包埋可产生高质量的组织和细胞形态，从而提高诊断可靠性并检测到毛细胞白血病的低分期浸润。DBA44似乎是一种高度特异性的标记毛细胞的抗体，因为只有免疫细胞瘤在少数病例中呈阳性反应。包括DBA44、CD20、CD45R和Ki-M1P在内的一小组抗体甚至在早期或残留肿瘤细胞极少时，也可用于区分小细胞非霍奇金淋巴瘤和毛细胞白血病。
