Kroft S H, Hsi E D, Ross C W, Schnitzer B, Singleton T P
University of Texas, Southwestern Medical School, Dallas 75235-9073, USA.
Mod Pathol. 1998 Oct;11(10):967-70.
The CD23 antigen is expressed in a normal subset of B lymphocytes and in some non-Hodgkin's lymphomas. Reactivity for anti-CD23 (BU38) is present in paraffin-embedded tissue in the large majority of nodal small lymphocytic lymphomas, as well as in follicular center cell lymphomas. Most studies of gastric lymphomas of mucosa-associated lymphoid tissue (MALT) reported a lack of CD23, but these studies were performed on frozen tissue. We evaluated CD23 staining in paraffin-embedded tissue in a large series of gastric MALT lymphomas, as well as in cases of chronic gastritis. We assayed 49 well-characterized gastric lymphomas (9 high-grade non-MALT and 40 MALT [20 low grade, 13 mixed low and high grade, and 7 high grade]). High-grade MALT lymphomas without a low-grade component were distinguished from high-grade non-MALT lymphomas by the presence of lymphoepithelial lesions composed of large cells. In addition, we studies nine cases of chronic gastritis containing B-cell aggregates. We used anti-CD23 (BU38) in formalin-fixed, paraffin-embedded tissue. All of our low-grade gastric MALT lymphomas lacked CD23 immunoreactivity. One of the 13 mixed low-grade and high-grade lesions showed CD23 expression in the high-grade component. All of the high-grade MALT and high-grade non-MALT lesions lacked CD23. All of the nine cases of chronic gastritis lacked CD23. CD23 highlighted residual follicular dendritic cells and gastric epithelium. We concluded that gastric MALT lymphomas lacked CD23 (BU38) in paraffin-embedded tissue, with rare exceptions. This lack of CD23 expression might represent a useful feature in small or partially crushed biopsy specimens, particularly in the differential diagnosis with follicular small cleaved cell lymphoma presenting in the gastrointestinal tract.
CD23抗原在正常B淋巴细胞亚群及某些非霍奇金淋巴瘤中表达。在大多数淋巴结小淋巴细胞淋巴瘤以及滤泡中心细胞淋巴瘤的石蜡包埋组织中，可检测到抗CD23（BU38）反应性。大多数关于黏膜相关淋巴组织（MALT）胃淋巴瘤的研究报告称缺乏CD23，但这些研究是在冷冻组织上进行的。我们评估了一大系列胃MALT淋巴瘤以及慢性胃炎病例石蜡包埋组织中的CD23染色情况。我们检测了49例特征明确的胃淋巴瘤（9例高级别非MALT淋巴瘤和40例MALT淋巴瘤[20例低级别、13例低级别与高级别混合、7例高级别]）。无低级别成分的高级别MALT淋巴瘤与高级别非MALT淋巴瘤的区别在于存在由大细胞组成的淋巴上皮病变。此外，我们研究了9例含有B细胞聚集物的慢性胃炎病例。我们在福尔马林固定、石蜡包埋的组织中使用抗CD23（BU38）。我们所有的低级别胃MALT淋巴瘤均缺乏CD23免疫反应性。13例低级别与高级别混合病变中有1例在高级别成分中显示CD23表达。所有高级别MALT和高级别非MALT病变均缺乏CD23。9例慢性胃炎病例均缺乏CD23。CD23突出显示了残留的滤泡树突状细胞和胃上皮。我们得出结论，胃MALT淋巴瘤在石蜡包埋组织中缺乏CD23（BU38），仅有罕见例外。CD23表达的缺失可能是小活检标本或部分挤压活检标本中的一个有用特征，尤其是在与胃肠道滤泡性小裂细胞淋巴瘤的鉴别诊断中。
