系统性间变性大细胞淋巴瘤的免疫组织化学特征

Immunohistochemical features of systemic anaplastic large cell lymphoma

目的:探讨系统性间变性大细胞淋巴瘤(anaplastic large cell lymphoma,ALCL)的免疫组织化学特征。方法:回顾性分析48例系统性ALCL的免疫组织化学和10例系统性ALCL原位杂交技术检测EBER(EBV-encoded small RNA)的结果。结果:48例系统性ALCL的肿瘤细胞均表达CD30,而间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)在41.7%(20/48)的病例阳性,其他指标阳性率为CD2为65.0%(26/40),CD3为36.2%(17/47),CD4为72.7%(16/22),CD5为42.9%(15/35),CD7为16.7%(5/30),上皮细胞膜抗原(epithelial membrane antigen,EMA)为65.6%(21/32),T细胞胞质内抗原(T-cell intracellular antigen-1,TIA-1)为79.2%(19/24),颗粒酶B(granzyme B-producing Breg,Gr B)为70.0%(14/20)。所有病例的B细胞标志(CD20,PAX5,CD79α)均阴性。10例系统性ALCL有2例出现部分肿瘤性大细胞E B E R阳性。结论:CD 3 0和A L K是诊断A LCL关键及较为特异的免疫指标;有时出现人类疱疹病毒第四型(Epstein–Barr virus,EBV)感染并不能排除ALCL的诊断。

Objective： To study the immunohistochemical characteristics of systemic anaplastic large cell lymphoma. Methods： A retrospective analysis of immunophenotype of 48 cases of systemic anaplastic large cell lymphoma and the result of EBV-encoded small RNA （EBER） expression with in situ hybridization of 10 cases was performed. Results： The tumor cells expressed CD30 in 48 cases ofALCL. Anaplastic lymphoma kinase （ALK） was positive in about 41.7% （20/48） cases. The positive rates of other antigens were 65.0% （26/40） of CD2, 36.2% （17/47） of CD3, 72.7% （16/22） of CD4, 42.9% （15/35） of CD5, 16.7% （5/30） of CD7, 65.6% （21/32）of epithelial membrane antigen （EMA）, 79.2% （19/24） of TIA-1, and 70.0% （14/20） of granzyme B-producing Breg （GrB）. All of the cases were negative for B-cell markers （CD20, PAX-5 and CD79a）. Two of I0 cases showed EBER positive in partial tumor cells. Conclusion： CD30 and ALK are the critical and relatively specific markers for ALCL; Epstein-Barr virus （EBV） involvement may not preclude the diagnosis of ALCL in some cases.