皮肤假性淋巴瘤组织病理与基因重排特点

Pathological and Gene Rearrangement Characteristics of Thirteen Cases of Cutaneous Pseudolymphoma

目的分析研究皮肤假性淋巴瘤(CPL)的组织病理、基因重排特点。方法对13例皮肤假性淋巴瘤的石蜡包埋组织,采用苏木精-伊红染色(HE染色法)、免疫组化SP法进行组织病理学检查,应用PCR行TCR-β和IgH基因重排检测。结果13例皮肤假性淋巴瘤组织病理示:真皮内淋巴样细胞大致呈带状浸润,无明显异形性,主要位于真皮浅层,细胞浸润与表皮之间有正常胶原带分隔。免疫组化显示浸润淋巴细胞呈混合型(CD20、CD3、CD45RO阳性)。13例CPL中,进行TCR-β基因重排时:10例出现smear带(76.9%),2例重排阳性(15.4%);IgH基因重排时:2例出现smear带(15.4%),无1例重排阳性(0%)。结论皮肤假性淋巴瘤的临床及组织病理表现形式多样;TCR-β和IgH基因重排检测,在诊断CPL方面具有重要价值。

Objective To investigate the Pathological and gene rearrangement characteristics. Methods The histopathological results of cutaneous pseudolymphomas（CPL） were studied by HE and immunohistochemical stainings. TCR - β and IgH gene rearrangements were analyzed by PCR assays, 18 cases of primary cutaneous malignant lymphomas （PCML） samples were used as controls. Results Result The histochemical examinations showed that an infiltration of lymphocytes in girdle - shape present in the superficial dermis. There was no cellular atypia the infiltrated cells. Immunohistochemical stain showed that the infiltrated lymphocytes of mixed types were positive to CD20. CD3 and CIM5RO. Using TCR - β PCR, monodonality was detected in 2 （ 15.4 % ） of 13 CPL compared with 14 （77.8 % ） of 18 PCML, while a polyclonal result was seen in 10（76.9 % ） of 13 CPL,compared with 1（5.5% ） of 18 PCML samples. None of the 13 CPL and 18 PCML samples were IgH PCR positive,2（15.4 % ） of 13 CPL and 4（22.2 % ） of 18 PCML samples showed polyclonal pattern, Conclusion TCR - β and IgH gene rearrangements is important in the diagnosis of CPL and provide the evidence for evaluating the prognosis of CPL. PCR