AILD和AILD-TCL的临床病理分析

Clinical pathology of angioimmunoblastic lymphadenopathy with dysproteinemia and angioimmunoblastic lymphadenopathy type of T-cell lymphoma: Correlation with expression of CD44 and Ki-67

目的 对血管免疫母细胞性淋巴结病和血管免疫母细胞性淋巴结病型T细胞性淋巴瘤进行临床病理、免疫组化及CD44和Ki 6 7表达的研究 ,进一步探讨二者的关系。方法 收集临床资料并随访 ,免疫组化采用S P法 ,对 35例次AILD及AILD TCL进行临床病理及免疫组化研究。结果 形态学上两组均出现淋巴结结构破坏、“烧光”的生发中心、血管增生、PAS阳性物质沉积 ,仅透明细胞的量有显著性差异 (P <0 0 5 )。 3例连续活检证实AILD TCL由AILD演进而来。 11例AILD及 2 0例AILD TCL均为T细胞性 ,均出现Ki 6 7表达 ,2例AILD TCL出现CD44v6的表达 ,7例AILD及 15例AILD TCL出现CD44s的表达 ,双重染色显示中等大透明细胞和免疫母细胞中可见Ki 6 7与CD44s的共表达。临床上AILD和AILD TCL多见于老年男性 ,有发热、淋巴结肿大、肝脾肿大、皮疹等症状 ,预后较差。结论 AILD与AILD TCL是同一疾患在不同阶段的表现 ,CD44s与临床分期相关 ,Ki 6

Objective To investigate the correlation of angioimmunoblastic lymphoadenopathy with dysproteinemia (AILD) with angioimmunoblastic lymphadenopathy type of T cell lymphoma (AILD TCL), and to assess the prognostic value of CD44 and Ki 67. Method Immunohistochemical staining (strepavidin biotin method) was performed on formalin fixed and paraffin embedded material to detect the expression of CD44 and Ki 67 in 11 cases of AILD and 20 AILD TCL. Results Histologically, this group of AILD and AILD TCL shared the similar morphological features, excepting that there existed more pale cells in AILD TCL than in AILD ( P <0.05). Expression of CD44 was observed in 7 samples of AILD and 15 AILD TCL. Expression of CD44v6 was detected in 2 samples of AILD TCL. There was co expression of CD44s and Ki 67 detected by double immunostaining. Clinically, most of the patients were old males with fever, lymphadenopathy, hepatosplenomegaly and rashes. The prognosis of the patients was poor. Conclusions AILD and AILD TCL are different stages of the same disease. Increase of CD44s positive cells is correlated with advanced stage of the disease ( P <0.05). Increase of Ki 67 positive cells may be correlated with a poor prognosis.