CD45RO阳性的B细胞性淋巴瘤

CD45RO positive B cell lymphoma

目的 研究免疫表型异常淋巴瘤的起源。方法 从 4 8例B细胞淋巴瘤中筛选出 3例CD4 5RO、CD2 0和CD79a(+) ,CD3(- )的淋巴瘤。采用免疫组化、PCR和基因扫描技术对其免疫表型 ,免疫球蛋白重链基因重排(IgH)和T细胞受体基因重排 (TCR)进行深入研究。结果 3例淋巴瘤均为结外淋巴瘤。 1例为滤泡性淋巴瘤 ,2例为弥漫性大B细胞性淋巴瘤。PCR和基因扫描显示 3例均有IgH克隆性扩增 ;PCR未显示TCR扩增 ;高敏感性基因扫描显示低峰值TCR克隆性扩增 ,提示可能为背景T细胞扩增。结论 CD4 5RO不是T细胞特异性抗原 ,CD4 5RO阳性细胞不能完全等同于T细胞 ,因此 ,在研究和临床病理诊断中应选用多种抗体配合使用。

Objective To clarify the origin of lymphomas with aberrant phenotype. Methods Using PCR and gene scanning techniques we analysed immunogloblin heavy chain (IgH) and T cell receptor (TCR) gamma gene rearrangements in 3 cases with expression of CD45RO, CD20 and CD79a but not CD3 in 48 cases of B cell non-Hodgkin's lymphoma from Inner Mongolia. Results In the 3 cases there were 1 male and 2 female patients with age 70, 32 and 43 years,respectively. All the lymphomas were from extranodular lymphoid tissues including tonsil, ileum and skin with 1 follicular lymphoma and 2 diffuse large B cell lymphoma. Clonal IgH gene rearrangement was successfully amplified in all cases, which was further confirmed in gene scanning analysis. On the other hand, TCR rearrangement was not detected in these cases, although there were a low peak in gene scanning in 2 of 3 cases. The low peak might rather represent clonal ampplification of the tumor cells than a few reactive T cells in the tissue. Conclusions The 3 cases of lymphoma with expression of CD45RO, CD20 and CD79a but not CD3 are derived from B cells. This finding shows that CD45RO is not specific antigen, suggesting that CD45RO positive cells are not automatically equal to T cells. Therefore, it is necessary to use combination of at least two sets of antibodies in research and clinical diagnosis of lymphomas.