滤泡树突状细胞表达模式变化在淋巴瘤病理鉴别诊断中的应用价值

Differential Diagnostic Value of Morphological Changes of Follicular Dendritic Cell Meshwork between Different Subtypes of Lymphoma

目的：探讨滤泡树突状细胞（follicular dendritic cell，FDC）网在各种类型淋巴瘤中的形态变化模式及其在鉴别诊断中的临床应用价值。方法采用免疫组化方法对56例各种类型的淋巴瘤进行 CD21免疫组化染色，观察 FDC网的形态变化模式。其中包括弥漫大B细胞淋巴瘤8例、伯基特淋巴瘤2例、小淋巴细胞性淋巴瘤6例、浆细胞瘤6例、MALT淋巴瘤3例、外周T细胞淋巴瘤6例、间变性大细胞淋巴瘤5例、NK／T细胞淋巴瘤8例、滤泡性淋巴瘤4例、套细胞淋巴瘤3例、AITL 3例、FDC肉瘤 2例。结果 FDC网在各种类型淋巴瘤中的形态变化可归为4种模式：①破坏消减型：绝大部分淋巴瘤 FDC网完全或部分破坏，包括弥漫大B细胞淋巴瘤、伯基特淋巴瘤、小淋巴细胞性淋巴瘤、浆细胞瘤、外周 T细胞淋巴瘤、间变性大细胞淋巴瘤、NK／T细胞淋巴瘤；②存在型：FDC网存在，甚至有数量增多，包括MALT淋巴瘤、滤泡性淋巴瘤、套细胞淋巴瘤；③增生紊乱型：FDC网增多、变形、紊乱，如 AITL；④全表达型：FDC网在肿瘤组织中每个细胞表达，如 FDC肉瘤。结论 FDC在各种类型淋巴瘤中存在不同的形态变化模式，在淋巴瘤鉴别诊断中具有重要的临床应用价值。

Objective To explore the differentiated diagnostic value of the morphological changes of follicular dendritic cell （FDC）meshwork between different subtype of lymphoma.Methods CD21 was stained by immunohistochemistry （IHC） method,FDC meshwork pattern was studied in 5 6 cases of various lymphomas（including 8 cases of diffuse large B cell lymphoma,2 cases of burkitts lymphoma,6 cases of small lymphocytic lymphoma,6 cases of plasmacytoma,3 cases of MALT lymphoma,6 cases of peripheral T cell lymphoma,3 cases of anaplastic large cell lymphoma,8 cases of NK/T cell lymphoma,4 cases of follicular lymphoma,3 cases of mantle cell lymphoma,3 cases of AITL,2 cases of FDC sarcoma）.Results FDC meshwork in the morphological changes of various subtypes of lymphoma could be classified into four patterns：①FDC form a disappeared and disintegrated meshwork,most of the lymphoma FDC meshwork fully or partially destroyed,including diffuse large B cell lymphoma,burkitt lymphoma,small lymphocytic lymphoma,plasmacytoma,peripheral T cell lymphoma, anaplastic large cell lymphoma,NK/T cell lymphoma;②FDC meshtwork existence,even hyperplasia,including follicular lymphoma,mantle cell lymphoma,MALT lymphoma;③FDC meshtwork proliferation,disorder and deformation,such as AITL;④Full expression subtype：such as FDC sarcoma.Conclusion The morphologic pattern of the FDC meshwork in lymphomas of follicular origin was differs according to the lymphoma subtypes,and it has important clinical value in lymphoma differential diagnostic.