Khalidi H S, Singleton T P, Weiss S W
Department of Pathology, University of Michigan Hospitals, Ann Arbor 48109-0054, USA.
Mod Pathol. 1997 May;10(5):438-42.
Inflammatory malignant fibrous histiocytoma (IMFH), consisting of large, atypical histiocyte-like cells set amidst an inflammatory backdrop of eosinophils, neutrophils, lymphocytes, and xanthoma cells, can be difficult to distinguish from Hodgkin's disease and non-Hodgkin's lymphoma, particularly of the Ki-1 anaplastic large-cell type in small biopsy specimens. This problem is becoming more prevalent with the use of needle biopsies guided by computed tomography for definitive diagnosis. For this reason, we studied the expression of a battery of leukocyte markers in IMFH to evaluate whether they could serve as an independently reliable means of distinguishing amongst the three neoplasms. Eight examples of histologically typical IMFH were stained with a number of leukocyte markers that included CD30 (BerH2), CD15 (leuM1), CD45/ CD45RB (2B11,PD7/26/16), CD43 (leu 22), CD45RO (A6), CD20 (L26), and CD68 (KPI). The large anaplastic tumor cells within IMFH consistently lacked CD30, CD15, CD45/CD45RB, CD43, CD45RO, and CD20. In one case, the anaplastic cells expressed CD68. Benign histiocytes within IMFH expressed CD68 and displayed variable expression of CD15, CD45/CD45RB, and CD43. The reactive lymphocytes consisted mostly of scattered small T cells with a few B cells, mainly within lymphoid aggregates. We conclude that the immunophenotypic profile of the anaplastic cells in IMFH (lack of CD15, CD30, CD43, CD45/CD45RB, CD45RO, CD20) differs from most cases of Hodgkin's disease (ICD30+, CD15+/-) and from Ki-1 anaplastic large cell lymphoma (CD30+, CD45/CD45RB+/-, CD43+/-, CD45RO+/-, CD20-/+). Immunohistochemistry is an important diagnostic adjunct, provided care is taken to exclude benign histiocytes and inflammatory cells from consideration.
炎症性恶性纤维组织细胞瘤（IMFH）由大的、非典型组织细胞样细胞组成，周围伴有嗜酸性粒细胞、中性粒细胞、淋巴细胞和黄色瘤细胞构成的炎症背景，在小活检标本中，它可能难以与霍奇金病和非霍奇金淋巴瘤区分开来，尤其是Ki-1间变性大细胞型。随着计算机断层扫描引导下的针吸活检用于明确诊断，这个问题变得越来越普遍。因此，我们研究了一系列白细胞标志物在IMFH中的表达，以评估它们是否可作为区分这三种肿瘤的独立可靠方法。8例组织学典型的IMFH用多种白细胞标志物进行染色，这些标志物包括CD30（BerH2）、CD15（leuM1）、CD45/CD45RB（2B11、PD7/26/16）、CD43（leu 22）、CD45RO（A6）、CD20（L26）和CD68（KPI）。IMFH内的大间变性肿瘤细胞始终缺乏CD30、CD15、CD45/CD45RB、CD43、CD45RO和CD20。在1例病例中，间变性细胞表达CD68。IMFH内的良性组织细胞表达CD68，并表现出CD15、CD45/CD45RB和CD43的可变表达。反应性淋巴细胞主要由散在的小T细胞和少数B细胞组成，主要存在于淋巴聚集区内。我们得出结论，IMFH中间变性细胞的免疫表型特征（缺乏CD15、CD30、CD43、CD45/CD45RB、CD45RO、CD20）与大多数霍奇金病病例（CD30+、CD15+/-）以及Ki-1间变性大细胞淋巴瘤（CD30+、CD45/CD45RB+/-、CD43+/-、CD45RO+/-、CD20-/+）不同。免疫组织化学是一项重要的诊断辅助手段，前提是要注意排除良性组织细胞和炎症细胞。
