B细胞特异性激活蛋白PAX-5在间变性大细胞淋巴瘤中的异常表达及意义

Expression and significance of BSAP (PAX-5) in anaplastic large cell lymphoma

目的研究PAX-5在间变性大细胞淋巴瘤中的异常表达情况,探讨PAX-5在淋巴瘤病理诊断和鉴别诊断中的意义以及鉴别诊断需注意的问题。方法回顾269例T细胞淋巴瘤病例,对经免疫组化、基因重排确诊的PAX-5异常表达的病例,结合文献调研,探讨其临床病理特征和意义。结果 269例T细胞淋巴瘤中,共发现2例间变性大细胞淋巴瘤异常表达PAX-5,异常表达PAX-5的肿瘤细胞同时表达T细胞标记。结论 PAX-5是比较特异的B细胞标记,但也可以表达于T细胞淋巴瘤。在淋巴瘤的诊断和分类,特别是某些经典霍奇金淋巴瘤和间变性大细胞淋巴瘤的鉴别诊断过程中,必须结合临床、病理形态学特点,合理选用并综合评价系列T、B免疫标记表达情况,必要时行基因重排检测,做出正确诊断。

Objective To investigate the expression of PAX-5 in anaplastic large cell lymphoma, discuss the value and pitfalls of PAX-5 in the diagnosis and differential diagnosis of lymphomas. Methods A total of 269 T lymphomas were studied retrospectively. PAX-5 positive anaplastic large cell lymphoma was confirmed by immo- mnnohistoehemistry and gene rearrangement analysis. Literature review was performed and the clinicopathological features were discussed. Results Two cases of anaplastic large cell lymphoma were found with aberrant expression of PAX-5. Conclusions As a relatively specific B cell marker, PAX-5 can also express in anaplastic large cell lymphoma. In the diagnosis of lymphomas, especially the differential diagnosis between classical Hodgkin lympho- ma and Anaplastie large-cell lymphoma, diagnosis errors should be avoided by interpreting PAX-5 immunohisto- chemistry in the context of clinical features, morphology, a panel of B- and T-lineage-associated antibodies, and gene rearrangement analysis.